2010—2012年上海市闵行区5岁以下儿童死亡监测结果分析

Analysis of Monitoring Results in the Death of Children Below 5 Years Old in Minhang District of Shanghai from 2010 to 2012

目的 分析5岁以下儿童死亡的具体情况,了解近3年闵行区儿童死亡的特征和规律,探讨进一步降低儿童死亡率的关键措施.方法 对2010-2012年闵行区5岁以下死亡儿童进行监测,以ICD-10进行死因分类,使用软件进行数据整理和统计分析.结果 2010-2012年,5岁以下儿童死亡率为11.52‰（680/59 026）,其中婴儿死亡率为8.97‰（529/59 026）,14岁儿童死亡率为2.56‰（151/59 026）.5岁以下死亡儿童中以婴儿为主,占79.29％.儿童死因前5位为：先天性心脏病、早产和低体重儿、感染、意外伤害和新生儿窒息.非户籍儿童5岁以下儿童死亡率显著高于户籍儿童（P＜0.01）,5岁以下儿童死亡率男童显著高于女童（P＜0.05）.结论 降低5岁以下儿童死亡率的关键在于降低婴儿死亡率.提高卫生保健服务,积极实施出生缺陷干预措施,完善危重新生儿转运机制,重视安全教育是降低5岁以下儿童死亡率的有力措施.

OBJECTIVE To describe the trends of infant mortality rate for infants below 5 years in Minhang District in recent 3 years, so as to figure out preliminary ways and strategies to decline IMR. METHODS All the data of infant death for infants below 5 years was obtained through infant mortality rate surveillance system, and ICD-10-CM is implemented to monitor the types of infant death. RESULTS From 2010 to 2012, the under 5 mortality rate IMR was 11.52%v; meanwhile, the IMR was 8.97%v. The infants count for 79.29% among the whole children below 5 years. The IMR of children with household register was much lower than children without significantly, and the IMR of boy babies was much higher than the girl babies significantly. The cause group making the top 5 contribution to infant mortality was the CHD, preterm and low birth weight, infection, accident and neonatal asphyxia. CONCLUSION The MR has been at a fairly steady pace during the past 3 years, and the effort of declining IMR has become increasing important. Increasing healthcare quality, implementing intervention on birth defect, applying the neonatal transport system mixed with emphasizing the importance of child safety education are all the preliminary ways and strategies of declining IMR.