广州市2016至2019年253例病残儿鉴定结果分析及干预措施探讨

Medical identification results and intervention measures of 253 disabled children in Guangzhou city from 2016 to 2019

目的分析广州市病残儿医学鉴定资料以了解其疾病种类及病种构成,探讨病残患儿发生的可能致病因素并提出对应的防治措施。方法采用回顾性研究方法,统计分析广州市2016年11月至2019年11月253例病残患儿的疾病特征及病种排序、高发地区的疾病分布等。结果0~5岁病残儿占95.26%(241/253),男女比例为1.22∶1;91例遗传性疾病以21-三体综合征、地中海贫血、先天性心脏病为多,162例非遗传性疾病发生系统主要集中于神经系统、血液系统疾病等;母亲生产年龄≥30岁、父母亲职业均为务农和待业、产检选择区镇医疗机构可能是病残儿的致病因素。结论重点加强增城区、白云区等育龄人群的优生指导工作力度,提供因人而异的宣传教育、便捷有效的途径以扩大优生健康教育广度和深度,增强基层医疗机构的硬件设施建设以保障产前筛查率和产前诊断能力,强化出生缺陷综合防治,最大限度减少出生缺陷及病残儿的发生。

Objective By analyzing the medical identification data of disabled children in Guangzhou,to understand disease types and composition,explore the possible pathogenic factors,and put forward corresponding control measures.Methods Using retrospective study method,the disease characteristics,sorts,and distribution of 253 disabled children in Guangzhou city from 2016 to 2019 were analyzed.Results The 0-5 years old disabled children accounted for 95.26%(241/253).The ratio of male to female was 1.22∶1.Among the 91 cases of hereditary diseases,21-trisomy syndrome,thalassemia,and congenital heart disease were the most common.Among the 162 cases of non-hereditary diseases,most had neurological and hematological diseases.The mothers'birth age≥30,farmer and unemployed parents,and town medical institutions for prenatal examination might be the causative factors of the disabled children.Conclusion According to the disease causes,we should strengthen the eugenics guidance for people of childbearing age at Zengcheng District and Baiyun District,apply individualized publicity and effective ways to expand the breadth and depth of health education,enhance the construction of hardware facilities in primary medical institutions to ensure prenatal diagnosis ability,and intensify comprehensive prevention of birth defects to minimize the occurrence of disabled children.