7970例新生儿住院病例分析

Analysis on 7970 Hospitalization Cases of Newborns

目的了解住院新生儿的疾病及死因构成,为新生儿疾病防治提供依据。方法以新生儿出生至28天为统计标准,将2004年-2011年出院的新生儿病例作为调查对象,出院主要诊断按ICD-10编码进行统计分类分析,总结出我院新生儿主要疾病及死因构成,比较不同病种的病死率;比较前后4年疾病谱及病死率的变化;处理采用Χ检验。结果 (1)新生儿病种前五位依次为:高胆红素血症、肺炎、早产儿、窒息/脑损伤、吸入性肺炎。前后4年比较,两时间段此五种疾病均多发,2007年设立新生儿病区后4年年均收治新生儿病人数翻一番。(2)主要疾病构成比重有了较大变化。非感染性疾病中,高胆红素血症增加显著,比重由前4年的27.05%升至后4年的48.37%(χ2=349.800,P<0.01);早产儿增加,比重由5.57%升至8.57%(χ2=24.005,P<0.01);感染性疾病比重下降,由37.45%降至22.41%(χ2=217.001,P<0.01)。(3)新生儿总病死率为5.8‰,由前4年的8.5‰降至后4年的4.1‰(χ2=6.545,P<0.05);主要死亡原因为早产、窒息及损伤性颅内出血、肺炎。结论设立新生儿病区后,对新生儿疾病的诊治加强,收治病人增加。随着医疗条件的改善,新生儿疾病谱有了显著改变,高胆红素血症发病率高,早产的发生较多,感染性疾病比重下降。新生儿病死率明显下降。加强围生期保健,实行产、儿科合作,做好高危儿的管理,对新生儿疾病防治有积极作用。

Objectives This paper aims at knowing about the formation of cause of death about newborns which provides basis for newborns＇ disease prevention.Methods As the statistical standard of 28 day post-born of newborns,newborns that were born from 2004 to 2011 are investigated.Main diagnosis of hospitalization classifies and analyzes by ICD-10 coding.It summarizes main diseases and formation of cause of death of newborns by comparing the mortality of different diseases.It compared the change of disease spectrum and mortality in former and later 4 years by using χ^2test.Results（1） The top disease categories of newborn are respectively hyperbilirubinemia,pneumonia,premature infants,asphyxia/brain injury,and aspiration pneumonia.By comparing the former 4 years and the later 4 years,these five disease occurred a lot in these two periods.Newborns patients increase one time 4 years after newborn ward building in 2007 per year.（2） The main disease constituent ratio greatly changed.Hyperbilirubinemia increases obviously in non-infectious disease.The constituent ratio increase from 27.05% in the earlier 4 years to 48.37% in the later years（χ^2=349.800,P〈0.01）;The ratio of premature infants increases from 5.57% to 8.57%（χ^2=24.005,P〈0.01）;the ratio of infectious disease decrease from 37.45% to 22.41%（χ^2=217.001,P〈0.01）.（3）The total mortality of newborns is 5.8‰,which decreases from 8.5‰ in the earlier 4 years to 4.1‰ in the later 4 years（χ^2=6.545,P〈0.05）;the main reasons of death are premature infants,asphyxia,traumatic intracranial haemorrhage and pneumonia.Conclusions After setting up newborn ward,the treatment of newborn disease strengthen with receiving increasing patients.With the improvement of medical conditions,newborn disease spectrum has obviously changed;the incidence of hyperbilirubinemia is high;the numbers of premature infants are huge;the ratio of infectious disease decreases;the mortality of newborns decreases obviously.Strengthening of healthcare during perinatal period,implement of cooperation between obstetrics and pediatrics and well management of high-risk infants may have positive effect to newborns disease.