2013-2017年余姚市5岁以下儿童死亡分析
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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(X~2=11. 693,P <0. 001)。经趋势X~2检验发现,5年来本地人口U5MR无明显下降趋势(X_(趋势)~2=0. 195,P=0. 658),而流动人口U5MR波浪式下降趋势明显(X_(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。
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 to2017 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 under5 years old( U5 MR) 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( X~2= 11. 693,P < 0. 001). The trend Chi-square test showed that the U5 MR in local residents had no obvious downward trend in the past5 years( X_(trend)~2= 0. 195,P = 0. 658),while the U5 MR in floating population significantly decreased with fluctuation( X_(trend)~2= 17. 706,P < 0. 001). Conclusion The key to reduce U5 MR 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 U5 MR.
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 to2017 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 under5 years old( U5 MR) 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( X~2= 11. 693,P < 0. 001). The trend Chi-square test showed that the U5 MR in local residents had no obvious downward trend in the past5 years( X_(trend)~2= 0. 195,P = 0. 658),while the U5 MR in floating population significantly decreased with fluctuation( X_(trend)~2= 17. 706,P < 0. 001). Conclusion The key to reduce U5 MR 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 U5 MR.
引文
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[9]罗波艳,梁芳,赵丽婷,等.兰州市2010-2014年5岁以下儿童死亡分析[J].中华疾病控制杂志,2016,20(7):683-686.DOI:10.16462/j.cnki.zhjbkz.2016.07.010.Luo BY,Liang F,Zhao LT,et al.Mortality analysis on children under 5 years old in Lanzhou City from 2010 to 2014[J].Chin JDis Control Prev,2016,20(7):683-686.DOI:10.16462/j.cnki.zhjbkz.2016.07.010.
[10]周桂珍,徐金,刘礼娇,等.某县5岁以下儿童死亡率变化趋势[J].中国卫生统计,2016,33(3):479-481.Zhou GZ,Xu J,Liu LJ,et al.Trend of mortality of children under 5 years old in a country[J].Chin J Health Statistics,2016,33(3):479-481.
[11]叶翔,俞飞燕,王道良.2011-2015年萧山区5岁以下儿童死亡分析[J].浙江预防医学,2016,28(5):523-526.Ye X,Yu FY,Wang DL.Mortality analysis of children under 5years old in Xiaoshan District from 2011 to 2015[J].Zhejiang Preventive Medicine,2016,28(5):523-526.
[12]张立明,张秀敏,马跃.吉林省5岁以下儿童出生缺陷影响因素病例对照研究[J].中华疾病控制杂志,2018,22(7):667-671.DOI:10.16462/j.cnki.zhjbkz.2018.07.004.Zhang LM,Zhang XM,Ma Y.A case-control study on influencing factors of birth defects in children under 5 years old in Jilin Province[J].Chin J Dis Control Prev,2018,22(7):667-671.DOI:10.16462/j.cnki.zhjbkz.2018.07.004.
[13]李鸿斌.基于《世界卫生统计2015》资料全球5岁以下儿童死亡率的现状分析[J].中国循证医学杂志,2017,17(3):269-275.DOI:10.7507/1672-2531.201701051.Li HB.Analysis of global under 5 years old mortality rate based on“World Health Statistics 2015”[J].Chin J Evidence-Based Medicine,2017,17(3):269-275.DOI:10.7507/1672-2531.201701051.
[14]宋文珍.预防和控制儿童意外伤害的基本对策[J].中国儿童保健杂志,2006,14(4):325.DOI:10.3969/j.issn.1008-6579.2006.04.001.Song WZ.Basic Measures for Preventing and Controlling Accidental Injuries in Children[J].Chin J Child Heal Care,2006,14(4):325.DOI:10.3969/j.issn.1008-6579.2006.04.001.
[15]柳林,韩铁丽,杨武悦,等.2006-2015年西安市5岁以下儿童意外伤害死亡分析[J].中国妇幼保健,2017,32(24):6263-6266.DOI:10.7620/zgfybj.j.issn.1001-4411.2017.24.70.Liu L,Han TL,Yang wy,et al.Analysis on accident death of children under 5 years old in Xi’an from 2006 to 2015[J].Maternal and Child Health Care of China,2017,32(24):6263-6266.DOI:10.7620/zgfybj.j.issn.1001-4411.2017.24.70.
[16]康晓平,符文华,王晓琴,等.农村地区5岁以下儿童死亡的性别差异及死因分析[J].中国预防医学杂志,2002,3(4):278-281.DOI:10.3969/j.issn.1009-6639.2002.04.008.Kang XP,Fu WH,Wang XQ,et al.Analysis on Causes of Death and Sex ratios of Child Under 5 years old in Rural Area[J].Chin Prev Med,2002,3(4):278-281.DOI:10.3969/j.issn.1009-6639.2002.04.008.
[2]王璟,张玲.北京市2006-2015年5岁以下儿童死亡监测趋势分析[J].中国公共卫生,2016,32(6):1364-1367.DOI:10.11847/zgggws2016-32-10-1.Wang J,Zhang L.Trend in mortality 0f children under 5 years old in Beijing,2006-2015[J].Chin J Publ Heal,2016,32(6):1364-1367.DOI:10.11847/zgggws2016-32-10-1.
[3]国家统计局.2017年《中国儿童发展纲要》(2011-2020年)》统计监测报告[EB/OL].(2018-11-09)[2018-11-22].http://www.stats.gov.cn/tjsj/zxfb/201811/t20181109_1632517.html.National Bureau of Statistics of China.Statistical monitoring report on the outline of China's children's development(2011-2020years)in 2017[EB/OL].(2018-11-09)[2018-11-22].http://www.stats.gov.cn/tjsj/zxfb/201811/t20181109_1632517.html
[4]国务院.中国儿童发展纲要(2011-2020年)[R].2011:3-4.The State Council of the People's Republic of China.China's program for children's development(2011-2020)[R].2011:3-4.
[5]夏冰洋,薛春梅,过燕.2012-2016年无锡市滨湖区5岁以下儿童死亡监测分析[J].现代预防医学,2017,44(22):4114-4117.Xia BY,Xue CM,Guo Y.Death monitoring analysis on children under 5 years old in Binhu district of Wuxi city from 2012 to 2016[J].Modern Preventive Medicine,2017,44(22):4114-4117.
[6]张贺艳,郭薇.盘锦市2005-2015年5岁以下儿童死亡状况分析[J].中国公共卫生,2016,32(11):1563-1566.DOI:10.11847/zgggws2016-32-11-3Zhang HY,Guo W.Mortality of children under 5 years old in Panjin municipality,2005-2015[J].Chin J Publ Heal,2016,32(11):1563-1566.DOI:10.11847/zgggws2016-32-11-3
[7]凌春瀛,吕莹波,吕兰秋,等.宁波市2006-2015年5岁以下儿童死亡分析[J].现代实用医学,2018,30(1):97-99.DOI:10.3969/j.issn.1671-0800.2018.01.050.Ling CY,Lv YB,Lv QL,et al.Mortality analysis on children under 5 years old in Ningbo City from 2006 to 2015[J].Modern Pract Med,2018,30(1):97-99.DOI:10.3969/j.issn.1671-0800.2018.01.050.
[8]王艳萍,朱军,缪蕾,等.中国2000~2006年5岁以下儿童死亡率和死亡原因分析[J].中华流行病学杂志,2009,30(5):466-470.DOI:10.3760/cma.j.issn.0254-6450.2009.05.013.Wang YP,Zhu J,Miu L,et al.Analys on under-5 mortality rate and the leading kinds of diseases in China,from 2000 to 2006[J].Chin J Epidemiol,2009,30(5):466-470.DOI:10.3760/cma.j.issn.0254-6450.2009.05.013.
[9]罗波艳,梁芳,赵丽婷,等.兰州市2010-2014年5岁以下儿童死亡分析[J].中华疾病控制杂志,2016,20(7):683-686.DOI:10.16462/j.cnki.zhjbkz.2016.07.010.Luo BY,Liang F,Zhao LT,et al.Mortality analysis on children under 5 years old in Lanzhou City from 2010 to 2014[J].Chin JDis Control Prev,2016,20(7):683-686.DOI:10.16462/j.cnki.zhjbkz.2016.07.010.
[10]周桂珍,徐金,刘礼娇,等.某县5岁以下儿童死亡率变化趋势[J].中国卫生统计,2016,33(3):479-481.Zhou GZ,Xu J,Liu LJ,et al.Trend of mortality of children under 5 years old in a country[J].Chin J Health Statistics,2016,33(3):479-481.
[11]叶翔,俞飞燕,王道良.2011-2015年萧山区5岁以下儿童死亡分析[J].浙江预防医学,2016,28(5):523-526.Ye X,Yu FY,Wang DL.Mortality analysis of children under 5years old in Xiaoshan District from 2011 to 2015[J].Zhejiang Preventive Medicine,2016,28(5):523-526.
[12]张立明,张秀敏,马跃.吉林省5岁以下儿童出生缺陷影响因素病例对照研究[J].中华疾病控制杂志,2018,22(7):667-671.DOI:10.16462/j.cnki.zhjbkz.2018.07.004.Zhang LM,Zhang XM,Ma Y.A case-control study on influencing factors of birth defects in children under 5 years old in Jilin Province[J].Chin J Dis Control Prev,2018,22(7):667-671.DOI:10.16462/j.cnki.zhjbkz.2018.07.004.
[13]李鸿斌.基于《世界卫生统计2015》资料全球5岁以下儿童死亡率的现状分析[J].中国循证医学杂志,2017,17(3):269-275.DOI:10.7507/1672-2531.201701051.Li HB.Analysis of global under 5 years old mortality rate based on“World Health Statistics 2015”[J].Chin J Evidence-Based Medicine,2017,17(3):269-275.DOI:10.7507/1672-2531.201701051.
[14]宋文珍.预防和控制儿童意外伤害的基本对策[J].中国儿童保健杂志,2006,14(4):325.DOI:10.3969/j.issn.1008-6579.2006.04.001.Song WZ.Basic Measures for Preventing and Controlling Accidental Injuries in Children[J].Chin J Child Heal Care,2006,14(4):325.DOI:10.3969/j.issn.1008-6579.2006.04.001.
[15]柳林,韩铁丽,杨武悦,等.2006-2015年西安市5岁以下儿童意外伤害死亡分析[J].中国妇幼保健,2017,32(24):6263-6266.DOI:10.7620/zgfybj.j.issn.1001-4411.2017.24.70.Liu L,Han TL,Yang wy,et al.Analysis on accident death of children under 5 years old in Xi’an from 2006 to 2015[J].Maternal and Child Health Care of China,2017,32(24):6263-6266.DOI:10.7620/zgfybj.j.issn.1001-4411.2017.24.70.
[16]康晓平,符文华,王晓琴,等.农村地区5岁以下儿童死亡的性别差异及死因分析[J].中国预防医学杂志,2002,3(4):278-281.DOI:10.3969/j.issn.1009-6639.2002.04.008.Kang XP,Fu WH,Wang XQ,et al.Analysis on Causes of Death and Sex ratios of Child Under 5 years old in Rural Area[J].Chin Prev Med,2002,3(4):278-281.DOI:10.3969/j.issn.1009-6639.2002.04.008.
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