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目的:了解嘉善县儿童及青少年死亡水平、主要死亡原因及变化趋势,为制订干预措施提供依据。方法:对嘉善县1986～2009年0～19岁年龄段全部死亡监测资料进行描述性分析。结果:0～19岁年龄段平均死亡率85.7/10万,标化死亡率59.9/10万,占全人群死亡数的2.86%。其中新生儿死亡率455.6/10万,出生后7天内死亡占74.5%;1岁以下婴儿死亡率753.9/10万,占5岁以下儿童死亡数的57.7%;5岁以下儿童死亡率254.0/10万,标化死亡率73.3/10万,0～14岁儿童死亡率101.1/10万,标化死亡率63.6/10万。前5位死因依次为伤害、先天异常、起源于围生期的某些情况、恶性肿瘤和呼吸系统疾病,占全部死亡人数的90.8%。各年龄组死亡率及前5位主要死因(除恶性肿瘤外)死亡率均呈现明显下降趋势。结论:加强孕产妇系统管理、儿童保健、计划免疫、安全防范,提高住院分娩和改善儿童营养等综合措施可以明显降低儿童死亡率,但仍需加强对伤害和先天异常的防治工作,以进一步降低儿童死亡率。
OBJECTIVE: To understand the level of death among children and adolescents in Jiashan County, the main causes and trends of death and provide the basis for the formulation of intervention measures. Methods: Descriptive analysis of all death monitoring data from 1986 to 2009 in Jiashan County from 0 to 19 years old was conducted. Results: The average mortality rate in 0 ~ 19 age group was 85.7 / 100000, the standardization mortality rate was 59.9 / 100000, accounting for 2.86% of the total population deaths. Among them, 455.6 / 100 000 were neonatal deaths and 74.5% were within 7 days after birth. Infant mortality rates were below 1 year old 753.9 / 100,000, accounting for 57.7% of all deaths of children under 5 years of age. The death rate of children under 5 years of age was 254.0 / 10 The standardized death rate was 73.3 / 100,000, the death rate of children aged 0-14 was 101.1 / 100,000, and the standardized death rate was 63.6 / 100,000. The top five causes of death were injuries, congenital anomalies, certain cases of perinatal origin, malignant tumors and respiratory diseases, accounting for 90.8% of all deaths. Mortality rates of all age groups and the top five major causes of death (except malignant tumors) showed a significant downward trend. Conclusion: Comprehensive measures such as strengthening maternal system management, child health care, planned immunization, safety precaution, improving hospital delivery and improving children’s nutrition can significantly reduce the child mortality rate. However, prevention and treatment of injuries and congenital abnormalities still need to be strengthened to further reduce Child mortality rate.