目的分析河南省7地市病残儿医学鉴定病种的变化趋势。方法利用国家卫生计生委科学技术研究所开发的《病残儿医学鉴定信息管理系统》收集2008-2014年河南省新乡、许昌等7个地市被鉴定为病残儿的病史资料,共3 973例。由专业人员采用SAS、R软件进行统计分析。结果病残儿年龄集中在5~9岁(50.42%),10岁以下的占77.83%;农村性别比(2.66)远高于城市(1.00),城市病残儿(2 529例)多于农村(1 443例);按照ICD-10疾病名称分类,排在前10位的疾病种类分别是先天性畸形、变形和染色体异常(1 351例),神经系统疾病(804例),眼和附器疾病(779例),精神和行为障碍(286例),耳和乳突疾病(160例),泌尿生殖系统疾病(153例),循环系统疾病(131例),血液及造血器官疾病和某些涉及免疫机制的疾患(117例),肿瘤(111例),内分泌、营养和代谢疾病(92例),构成比分别为26.66%、15.87%、15.37%、5.64%、3.16%、3.02%、2.59%、2.31%、2.19%、1.82%;经统计分析,心脏的其他先天性畸形、视觉障碍、大脑性瘫痪、癫痫、屈光和调节疾患等8个病种每年均进入前10位。而心脏的其他先天性畸形、视觉障碍、大脑性瘫痪3种病种顺位总是居前;从疾病构成比看,心脏的其他先天性畸形2014年构成比从9%明显上升为12%;视力障碍、屈光和调节疾患,2014年构成比从8%上升为12%;脑瘫构成比6年内呈现降低趋势。结论心脏的其他先天性畸形、视觉障碍、大脑性瘫痪为7地市病残儿医学鉴定的主要病种,心脏的其他先天性畸形、视力障碍、屈光和调节疾患呈上升趋势,脑瘫呈下降趋势。 Objective To analyze the changing trend of medically identified diseases of disabled children in 7 cities of Henan Province. Methods A total of 3 973 medical records of disabled children were collected from 7 prefectures and cities of Xinxiang and Xuchang in Henan Province during 2008-2014 using the “Information Management System for Medical Identification of Disabled Children” developed by the Institute of Science and Technology of the National Health and Family Planning Commission. example. By professionals using SAS, R software for statistical analysis. Results The age of disabled children was concentrated in 5 to 9 years (50.42%) and 77.83% in those under 10 years old. The rural sex ratio (2.66) was much higher than that in urban areas (1.00), and the urban disabled children (2 529 cases) (1 443 cases). According to the names of ICD-10 diseases, the top 10 diseases were congenital malformations, deformities and chromosomal abnormalities (1 351 cases), neurological diseases (804 cases), eyes and appendages (779 cases), mental and behavioral disorders (286 cases), ear and mastoid disease (160 cases), genitourinary system disorders (153 cases), circulatory diseases (131 cases), blood and hematopoietic disorders and some (117 cases), tumors (111 cases), endocrine, nutritional and metabolic diseases (92 cases) with immunological mechanism, the constituent ratios were 26.66%, 15.87%, 15.37%, 5.64%, 3.16%, 3.02%, 2.59 %, 2.31%, 2.19% and 1.82% respectively. According to statistical analysis, the other 10 congenital malformations, visual disturbances, cerebral palsy, epilepsy, refractive and regulatory disorders of the heart were among the top ten in each year. The other congenital malformations of the heart, visual disturbances and cerebral palsy always rank among the top 3 diseases. From the aspect of disease composition, the proportions of other congenital malformations in the heart increased significantly from 9% to 12% in 2014; Visual impairment, refractive and adjustment disorders, the composition ratio increased from 8% to 12% in 2014; the cerebral palsy constitutional proportion showed a decreasing trend in 6 years. Conclusions The other congenital malformations, visual disturbances and cerebral palsy in the heart are the major medical problems identified by the disabled in 7 cities. Other congenital malformations, visual disturbances, refractive and adjustment disorders of the heart are on the rise. Cerebral palsy is decreased trend.