1996～2000年中国脐膨出的流行病学调查

An epidemiological study on omphalocele in China during 1996 to 2000

目的 了解 1996～ 2 0 0 0年我国脐膨出的发生水平、流行病学特征和基本状况。方法在全国 31个省、直辖市、自治区的 4 6 0所县级或县级以上医院进行监测 ,监测对象为孕 2 8周至产后7d的围产儿 ,包括活产、死胎和死产。结果 1996～ 2 0 0 0年全国共监测围产儿 2 2 186 16例、脐膨出患儿 338例 ,全国脐膨出发生率为 1 5 2 /万。其中城市发生率为 1 4 0 /万 ,农村发生率为 1 83/万 ;男性发生率为 1 5 4 /万 ,女性发生率为 1 4 1/万。脐膨出伴发畸形率为 30 77% ,围产期死亡率为 5 1 18% ,产前诊断率为 31 0 7%。结论 1996～ 2 0 0 0年全国脐膨出发生率呈上升趋势 ,农村的发生率高于城市 ,脐膨出患儿围产期死亡率高 ,多发性脐膨出的死亡率高于单发性 ,应加强围产期管理和提高产前诊断水平。

Objective To understand the trend of incidence of omphalocele and its epidemiological characterisitics in China during 1996 to 2000. Methods Surveillance data of omphalocele were collected from 460 hospitals at county level or above county level, involving all births with 28-week gestation to 7 days after delivery, including live births, fetal deaths and stillbirths in 31 provinces, autonomous regions and municipalities all over the country during 1996 to 2000. Results Overall incidence of omphalocele in China was 1.52 per 10 000 live births, with an increasing trend during 1996 to 2000. Incidence of omphalocele was 1.40 per 10 000 and 1.83 per 10 000 in the rural and urban areas, respectively, with a statistically significant difference (P<0.05), and 1.54 per 10 000 and 1.41 per 10 000 in boys and girls, respectively. Babies of omphalocele associated with other malformation accounted for 30.77% of the total cases. Perinatal fatality rate of omphalocele was 51.18%, with prenatal diagnostic rate of 31.07%. Conclusions Prevalence of omphalocele appeared an increasing trend in China during the period from 1996 to 2000. Occurrence of omphalocele was more frequent in rural areas than that in urban areas. Perinatal fatality rate in babies with omphalocele was higher and fatality of associated omphalocele was higher than that of simple one. It is suggested that management of perinatal care and level of prenatal diagnosis for omphalocele should be improved.