成都市儿童医院住院新生儿20年疾病谱及病死率的变化

The varied trend of the newborn disease and death rate from inpatient newborns of Chengdu Children Hospital during 20 years

目的通过分析成都市儿童医院新生儿住院疾病谱和病死患儿资料,了解疾病构成和死亡分布的变化.方法将1981～2000年成都市儿童医院20年来住院患儿的第一诊断分为感染性与非感染性两大类,并按照4个年段,进行疾病构成和病死率比较.结果感染性疾病的构成比由89%降至72%;母乳性黄疸已升至近五年来非感染性疾病住院的第二位;两大类疾病的总病死率第1、2年段与第3、4年段相比,感染性疾病呈下降趋势(P＜0.05),非感染性疾病的总病死率无明显下降(P＞0.05).结论成都地区母婴卫生保健水平整体有所提高;窒息、先天畸形、早产、颅内出血等非感染性疾病的防治仍较严峻,大力提倡产前检查、监测及住院分娩,可能会使以上疾病的发生率下降.

Objective The data of in-patient newborn disease and death rate in the Chengdu Children Hospital from 1981 to 2000 were analysed to study the trend of the disease constituent and death distribution. Methods According to the first diagnosis of the inpatient newborns we classified them into two groups, infective diseases and non-infective ones. They were further divided into four year-stages and compared the disease constituent and death rate. Results The constituent ratio of infective diseases has dropped from 89% to 72%. Breast feeding-induced jaundice has risen up to the second place among non-infective diseases in inpatient newborns during recent 5 years. Compared with the 3 and 4 year-stages, the total death rate of infective diseases in the 1 and 2 year-stages showed a dropping trend (χ~2=6.511, P<0.05). The total death rate of non-infective diseases had no obvious changes (χ~2=0.783, P>0.05). Conclusion The health care level of mother and infant in Chengdu area has generally been improved, but it is still cumbersome and challenging to treat some non-infective diseases such as choke, congenital malformation,premature birth, intracranial bleeding, etc. Measures as improvement of antenatal examination and care, and advocacy of hospitalized delivery may greatly reduce the incidence of these diseases.