1990～2000年新生儿病死率回顾

A Retrospective Study of Neonatal Mortality During 1990 and 2000

目的 探讨在地区围产中心建立新生儿科和新生儿重症监护病室 (NICU )对新生儿病死率的影响。 方法 (1)调查和比较 :创建新生儿科 NICU前后 ,即 1990年 1月 1日～ 1992年 12月31日 (A组 ) 172 83例新生儿和 1993年 1月 1日～ 2 0 0 0年 12月 31日 (B组 ) 32 716例新生儿病死率 ,极低出生体重儿 (VL BW)和三胞胎四胞胎存活率。 (2 )调查 NICU逐步完善过程中新生儿病死率 ,VL BW存活率。(3) 1996年 NICU对外开放后该地区新生儿死亡率。 结果 (1)新生儿病死率 :A组为 8.6 2‰ ,B组 3.0 0‰。校正病死率分别为 6 .36‰和 1.74‰ (χ2 =71.33,P<0 .0 1)。 VL BW存活率 :A组 39.3% ,B组 87.6 %。B组 1例四胞胎、7例三胞胎 10 0 %存活。(2 ) NICU逐步完善过程中新生儿病死率进一步下降 1998～ 2 0 0 0年为 1.38‰ ,1998～ 2 0 0 0年 VL BW存活率 92 .5 %。 (3) NICU对外开放后 1998～ 2 0 0 0年新生儿死亡率城区为 4 .79‰ ,郊区为 6 .4 5‰。 结论 创建 NICU后新生儿、VL BW、四胞胎、三胞胎存活率明显提高。随着 NICU逐步完善 ,新生儿和 VL

Objective To investigate the influence of setting up of Division of Neonatology and Neonatal Intensive Care Unit(NICU) on neonatal mortality rate(NMR) in local perinatal center. Methods (1) NMR and survival rate of very low birth weight (VLBW) infants and triplet and quadruplet from 17283 newborns during Jan 1,1990 and Dec 31,1992 before NICU was set up (group A) were cmpared to that from 32 716 newborns during Jan 1,1993 and Dec, 31,2000, after NICU was set up(group B).(2) NMR and survival rate of VLBW infants in the process of NICU was developed was investigated. (3)NMR after the NICU was opened to the whole community. Results (1)NMR was 8.62 per 1000 in group A and 3.00 per 1000 in group B. Corrected Mortality Rates was 6.36 per 1000 and 1.74 per 1000 respectively (P <0.01). Survival Rate of VLBW infants was 39.3% in group A and 87.6% in group B. One quadruplet and 7 triplets were all survived after NICU was set up. (2)NMR and survival rate of VLBW infants were 1.39 per 1 000 and 92.5% in 1998 to 2000 respectively. (3)NMR after NICU was opened to the community was 4.79 per 1 000 in downtown area and 6.45 per 1 000 in suburbs in 1998～2000. Conclusion NMR, survival rates of VLBW infants, triplets and quadruplet have increased since NICU was set up. With the development of NICU, mortality of newborn and VLBW reduced progressively. NMR in the downtown area is in advanced level in China.