2006-2010年开化县5岁以下儿童死亡监测分析

Deaths monitoring among children under five in Kaihua county from 2006 to 2010

目的:了解开化县5岁以下儿童死亡率现况及变化趋势,分析主要死亡原因,为制定干预措施,进一步控制和降低死亡率提供科学依据。方法:按照《中国5岁以下儿童死亡监测方案》,收集开化县2006-2010年监测地区5岁以下儿童死亡监测资料,并对5岁以下儿童死亡的相关因素进行统计分析。结果:2010年开化县5岁以下儿童死亡率、婴儿死亡率、新生儿死亡率分别为8.5‰、5.7‰、4.0‰,较2006年分别下降8.6%、30.5%、18.4%。5岁以下儿童死亡的主要原因是先天性心脏病、早产和低出生体重、其他先天异常、溺水、其他新生儿病。新生儿期、婴儿期、1～4岁3个年龄段儿童首位死因分别为早产和低出生体重、先天性心脏病和溺水。儿童死前未进行治疗比例由2006年的29.4%下降至2010年的6.7%,死前诊断级别以县(区)以上为主,占77.1%,儿童死在家中的比例逐年下降。结论:开化县5岁以下儿童死亡率总体呈徘徊下降趋势。要进一步加强孕期、围产期保健和孕期监测,提高产科、儿科人员的专业技术水平,开展优生咨询、产前诊断和新生儿疾病筛查,加强1～4岁儿童安全管理,防范意外事件的发生,从而降低5岁以下儿童死亡率。

Objective To explore the status quo and trend of mortality among children under 5 years old and to analyze the main death causes among these children,which will provide intervention measures and scientific basis for further control and reduction of the mortality rate of these children.Methods According to monitoring program of deaths for children under 5 years old,death data of children under 5 in Kaihua county from 2006 to 2010 were collected and analyzed in all the related factors of death among these children.Results Compared to the year 2006,the mortality rates in 2010 of children under 5,infant and neonatus from Kaihua decreased by 8.6%,30.5%,and 18.4%,respectively,while the mortality rates of these children in 2010 were 8.5‰,5.7‰,and 4.0‰.The main death causes for children under 5 included congenital heart disease,premature birth,low birth weight,drowning and other neonatal diseases and congenital abnormalities.The first causes of death for neonatus,infant and 1-4 years old children were premature and low birth weight,congenital heart disease and drowning,respectively.The rate of children without treatment before death in 2006 was 29.4%,while the rate in 2010 decreased to 6.7%.Meanwhile,the rate of children who died at home was also declined year by year,with the diagnostic levels before death mostly belonged to county（district） or above.The rate was 77.1%.Conclusion The mortality of children under 5 in Kaihua was declining.We should further strengthen the pregnancy monitoring and perinatal care for pregnant women.In addition,we should also improve the technical level of the obstetrician and pediatrician,carry out eugenic counseling,prenatal diagnosis and neonatal screening,then enhance the security management for children under 5 and prevent the occurrence of accidents to reduce the mortality of children under 5 years old.