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目的通过分析2003-2011年云南省玉龙县5岁以下儿童死亡情况,掌握5岁以下儿童死亡的主要死因以及相关因素。方法采用描述性分析和χ2检验等方法分析2003-2011年玉龙县5岁以下儿童死亡监测资料及评审资料。结果 2011年5岁以下儿童死亡率12.86‰、婴儿死亡率10.62‰、新生儿死亡率6.71‰;与2003年相比分别下降了34.07‰、29.36‰、22.84‰,下降幅度分别为72.60%、73.43%、77.30%。玉龙县婴儿死亡占5岁以下儿童死亡比例为82.84%;新生儿死亡占婴儿死亡的比例为70.72%;早期新生儿死亡占新生儿死亡的比例为77.34%。5岁以下儿童死因顺位:早产/低体重、先天异常、意外死亡、出生窒息。5岁以下儿童死亡率与住院分娩率及孕产妇系统管理率呈负相关,相关系数分别为-0.917、-0.950。结论 9年监测资料显示,新生儿、婴儿、5岁以下儿童死亡下降速度均较快,说明加强对基层保健人员动员住院分娩、高危儿管理,产(儿)科医生掌握新生儿窒息复苏适宜技术,是降低5岁以下儿童死亡的有力措施;早产/低体重、先天异常、意外死亡已成为影响该地区儿童生存和发展的主要危险因素。提示,应加强婚前医学检查、孕前及孕期保健指导,提高产科质量,加强新生儿访视,对能引起先天异常的各种因素及时干预、预防,减少出生缺陷的发生,提高人口素质。
Objective To analyze the deaths of children under 5 years of age in Yulong County, Yunnan Province during 2003-2011, and to find out the main causes of death and related factors of deaths among children under 5 years of age. Methods Descriptive analysis and χ2 test were used to analyze the death monitoring data and assessment data of children under 5 years old in Yulong county from 2003 to 2011. Results In 2011, the death rate of children under 5 years old was 12.86 ‰, the infant mortality rate was 10.62 ‰, and the neonatal mortality rate was 6.71 ‰. Compared with 2003, the mortality rate dropped by 34.07 ‰, 29.36 ‰ and 22.84 ‰, down by 72.60% and 73.43, respectively %, 77.30%. Yulong County, infant deaths accounted for 82.84% of children under the age of 5 deaths; neonatal deaths accounted for 70.72% of infant deaths; early neonatal deaths accounted for 77.34% of neonatal deaths. The cause of death among children under 5 years old: premature birth / low birth weight, congenital anomaly, accidental death, birth asphyxia. The mortality rate of children under 5 years of age was negatively correlated with hospital delivery rate and maternal system management rate. The correlation coefficients were -0.917 and -0.950 respectively. Conclusion The 9-year monitoring data showed that neonatal and infant mortality rates dropped rapidly under the age of 5, indicating that it is necessary to intensify the efforts of grass-roots health workers to mobilize hospital delivery and management of high-risk infants, and that obstetricians and gynecologists master the appropriate technology for resuscitation of neonatal asphyxia Is a powerful measure to reduce the death of children under 5 years of age. Premature birth / low birth weight, congenital anomalies and accidental death have become the major risk factors affecting the survival and development of children in this area. Prompted that premarital medical examination should be strengthened, before and during pregnancy health guidance, improve the quality of obstetrics, strengthen neonatal visits, can cause congenital anomalies of various factors in a timely manner to prevent, reduce birth defects and improve the quality of the population.