2013-2017年余姚市5岁以下儿童死亡分析

胡波波; 傅克本; 胡碧波

doi:10.16462/j.cnki.zhjbkz.2019.02.011

2013-2017年余姚市5岁以下儿童死亡分析

doi: 10.16462/j.cnki.zhjbkz.2019.02.011

1.
154000 佳木斯, 佳木斯大学公共卫生学院预防医学系
2.
315400 余姚, 余姚市疾病预防控制中心慢性病防制科

详细信息

通讯作者:
胡碧波, E-mail: ckj_candy@163.com

中图分类号: R181.22;R179
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- 被引次数: 0
出版历程
- 收稿日期: 2018-08-31
- 修回日期: 2018-11-22
- 刊出日期: 2019-02-10

Mortality analysis on children under 5 years old in Yuyao County from 2013 to 2017

HU Bo-bo¹,
FU Ke-ben²,
HU Bi-bo^{2
, ,}

1.
Department of Preventive Medicine, School of Public Health, Jiamusi University, Jiamusi 154000, China
2.
Yuyao Center for Disease Control and Prevention, Department of Chronic Disease Prevention and Control, Yuyao 315400, China

More Information

Corresponding author: HU Bi-bo, E-mail: ckj_candy@163.com

摘要

摘要: 目的分析2013-2017年余姚市5岁以下儿童死亡现状及主要死因，为制定相关干预措施提供科学依据。方法收集2013-2017年余姚市5岁以下儿童死亡监测资料，应用SPSS 18.0软件对5岁以下儿童的死亡趋势、死因顺位、地区差异和死前医疗保健服务利用情况等进行回顾性分析。结果 2013-2017年余姚市新生儿、婴儿、1~4岁儿童、5岁以下儿童死亡率（under 5 mortality rate，U5MR）均有下降趋势（P=0.016，0.002，0.038，＜0.001）。监测死亡病例263例，5岁以下儿童死亡以婴儿为主，占68.82%（181/263），先天畸形和意外伤害是5岁以下儿童主要死因。5岁以下儿童死亡地点以医疗机构为主，且93.54%的儿童接受过死前治疗，男童死亡率10.50‰，是女童死亡率的1.54倍（χ²=11.693，P<0.001）。经趋势χ²检验发现，5年来本地人口U5MR无明显下降趋势（χ_趋势²=0.195，P=0.658），而流动人口U5MR波浪式下降趋势明显（χ_趋势²=17.706，P<0.001）。结论降低余姚市U5MR的关键是降低婴儿死亡率，而死亡干预的重点内容是预防先天畸形及意外伤害。继续做好妇幼保健工作和大力开展流动儿童安全教育是降低U5MR的两项有效举措。
- 5岁以下儿童 /
- 死亡率 /
- 死亡原因 /
- 干预措施
Abstract: Objective To understand the status and main causes of death among children under five years old in Yuyao County from 2013 to 2017, and to provide scientific basis to formulate relevant intervention measures. Methods Data monitoring deaths among children under five years old from 2013 to 2017 in Yuyao were collected. Trend of death, death rank, regional difference and utilization of pre-death health care services for children under 5 years old were retrospectively analysed using SPSS 18.0. Results From 2013 to 2017, the mortality rate in newborns, infants, 1-4 years old children and children under 5 years old (U5MR) decreased in Yuyao county(P=0.016, 0.002, 0.038, <0.001). Based on monitored 263 cases of deaths, the majority of deaths of children under 5 years old occurred in infants, accounting for 68.82% (181/263). Congenital malformation and unintentional injury were the main causes of death for children under 5 years old. The deaths of children under 5 years old mainly occurred in medical institutions, and 93.54% of the children were treated before death. The mortality rate of boys under 5 years old was 10.50‰, which was 1.54 times of the mortality of girls (χ²=11.693, P<0.001). The trend Chi-square test showed that the U5MR in local residents had no obvious downward trend in the past 5 years (χ_trend²=0.195, P=0.658), while the U5MR in floating population significantly decreased with fluctuation (χ_trend²=17.706, P<0.001). Conclusion The key to reduce U5MR in Yuyao is to reduce infant mortality, and the key content of death intervention is to prevent congenital malformations and unintentional injuries. Improving maternal and child health care and developing safety education for migrant children are two effective measures to reduce U5MR.
- children under 5 years old /
- mortality rate /
- cause of death /
- intervention measures

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图 1 2013-2017年余姚市本地与流动人口5岁以下儿童死亡率变化(‰)

Figure 1. Changes in local and migrant mortality rates among children under 5 years old in Yuyao county, 2013-2017(‰)

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表 1 2013-2017年余姚市5岁以下儿童死亡情况

Table 1. Deaths of children under 5 years old in Yuyao county, 2013-2017

年度	活产数	新生儿		婴儿		1~4岁儿童		5岁以下儿童
年度	活产数	死亡数(男/女)	死亡率(‰)	死亡数(男/女)	死亡率(‰)	死亡数(男/女)	死亡率(‰)	死亡数(男/女)	死亡率(‰)
2013	5 547(2 889/2 658)	36(19/17)	6.49	54(32/22)	9.73	17(11/6)	3.06	71(43/28)	12.80
2014	5 572(2 869/2 703)	17(12/5)	3.05	29(19/10)	5.20	21(13/8)	3.77	50(32/18)	8.97
2015	6 228(3 296/2 932)	25(17/8)	4.01	41(29/12)	6.58	20(17/3)	3.21	61(46/15)	9.79
2016	6 069(3 169/2 995)	13(7/6)	2.14	19(9/10)	3.13	12(7/5)	1.98	31(16/15)	5.11
2017	6 694(3 412/3 282)	25(16/9)	3.73	38(22/16)	5.68	12(5/7)	1.79	50(27/23)	7.47
χ_趋势²值			5.832		9.581		4.3171		3.951
P值			0.016		0.002		0.038		＜0.001

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表 2 2013-2017年余姚市5岁以下儿童主要死因顺位

Table 2. Rank of death causes in children under 5 years old in Yuyao county, 2013-2017

死因顺位	新生儿			婴儿			1~4岁儿童			5岁以下儿童
死因顺位	死因	例数	构成比(%)	死因	例数	构成比(%)	死因	例数	构成比(%)	死因	例数	构成比(%)
1	先天畸形	29	25.00	先天畸形	40	22.10	溺水	37	45.12	先天畸形	47	17.87
2	早产/低体重出生	25	21.55	意外窒息	34	18.78	交通意外	8	9.76	意外窒息	37	14.07
3	出生窒息	23	19.83	早产/低体重出生	25	13.81	先天畸形	7	8.54	溺水	37	14.07
4	新生儿呼吸窘迫综合征	14	12.07	出生窒息	23	12.71	意外跌落	4	4.88	早产/低体重出生	25	9.51
5	新生儿败血症	7	6.03	肺炎	10	5.52	婴儿肿瘤	4	4.88	出生窒息	23	8.75

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表 3 2013-2017年余姚市5岁以下儿童死前医疗保健服务利用情况

Table 3. Utilization of pre-death health care services for children under 5 years old in Yuyao county, 2013-2017

类别	新生儿		婴儿		1~4岁儿童		5岁以下儿童
类别	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)
死亡地点
医疗卫生机构	73	62.93	103	56.91	42	51.22	145	55.13
家中	39	33.62	66	36.46	25	30.49	91	34.60
来医途中	4	3.45	12	6.63	15	18.29	27	10.27
死前治疗
未治疗	5	4.31	12	6.63	5	6.10	17	6.46
治疗	111	95.69	169	93.37	77	93.90	246	93.54
诊断级别
省市级	18	15.52	32	17.68	10	12.20	42	15.97
县区级	94	81.03	140	77.35	56	68.29	196	74.52
乡级	4	3.45	5	2.76	14	17.07	19	7.22
未诊断	0	0.00	4	2.21	2	2.44	6	2.28

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