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目的:分析5岁以下儿童死亡原因和变化趋势,为降低5岁以下儿童死亡率提供干预措施。方法:按浙江省5岁以下儿童死亡监测实施方案的要求,收集整理嘉善县2008~2013年5岁以下儿童死亡监测资料进行统计分析,儿童死因诊断和分类采用国际疾病分类(ICD-10标准)。结果:嘉善县2008~2013年5岁以下儿童平均死亡率为9.33‰,呈下降趋势,差异有统计学意义(χ2=12.02,P<0.005);5岁以下儿童死亡原因前6位顺位为:早产和低出生体重、溺水、先天性心脏病、出生窒息、意外窒息和其他先天异常;非本地户籍新生儿、婴儿及5岁以下儿童死亡率均高于本地户籍的死亡率;非本地户籍儿童接受死前保健服务水平低于本地户籍儿童。结论:要降低5岁以下儿童死亡率,关键在于加强孕产期保健,健全儿童保健管理模式,重点提高流动人口保健服务质量,控制儿童意外死亡。
Objectives: To analyze the causes and trends of death among children under 5 years old and provide interventions to reduce the mortality rate of children under 5 years of age. Methods: According to the requirements of the implementation plan of death monitoring for children under 5 years old in Zhejiang Province, the data of death monitoring of children under 5 years old in Jiashan County from 2008 to 2013 were collected for statistical analysis. The diagnosis and classification of child death cause were classified according to International Classification of Diseases (ICD-10) . Results: The average death rate of children under 5 years of age from 2008 to 2013 in Jiashan County was 9.33 ‰, showing a decreasing trend with a significant difference (χ2 = 12.02, P <0.005). The top 6 deaths among children under 5 years old were : Premature birth and LBW, drowning, congenital heart disease, birth asphyxia, accidental asphyxia and other congenital anomalies. Non-local births, infants and children under 5 years of age have higher mortality rates than local ones. Non-local residents The level of pre-mortem health care for children is lower than that of local registered children. Conclusion: To reduce the mortality rate of children under 5 years of age, the key is to strengthen maternal health care, improve child health management, focusing on improving the quality of services for migrant workers, and control the accidental death of children.