云南省2015—2019年儿童青少年意外伤害死亡原因分析

Mortality and causes of accidental injury among children and adolescents aged 5-19 in Yunnan Province during 2015-2019

目的探讨2015—2019年云南省儿童青少年意外伤害死亡的流行病学特点,为制定预防儿童意外死亡的干预措施提供参考依据。方法对2015—2019年云南省儿童青少年意外伤害死亡病例性别分布、年龄组分布、死因顺位等特征作回顾性分析,采用Poisson回归模型估计死亡率的变化趋势,χ^(2)检验比较不同性别和不同年龄段间死亡率的差异。结果云南省5~19岁儿童青少年意外伤害粗死亡率从2015年的19.15/10万下降至2019年的18.35/10万(Z=-3.36,P<0.01)。道路交通事故、溺水、意外跌落、其他意外伤害、意外中毒、火灾死亡率男生均高于女生(χ^(2)值分别为867.01,11.69,147.60,190.34,7.23,702.97,P值均<0.05)。意外伤害前3位死因为道路交通事故、溺水、意外跌落。除了意外跌落外,道路交通事故、溺水、其他意外伤害、意外中毒、火灾、全意外伤害死因15~19岁组死亡率高于5~9和10~14岁组(χ^(2)值分别为764.47,75.91,31.75,9.24,114.96,327.64,P值均<0.05)。前3位交通类型事故为骑(乘)摩托车人员的损伤、轻型货车或篷车事故损伤和驾(乘)小汽车人员的损伤,分别占27.83%,10.57%和7.90%。讨论需根据不同地区、年龄阶段、性别的儿童青少年特点采取针对性措施,减低儿童意外伤害发生率和死亡率。

Objective To explore the epidemiological characteristics of mortality of accidental injury children aged 5-19 years in Yunnan Province during 2015-2019,to provide further evidence for reducing accidental mortality in children.Methods The mortality cases of accidental injury by gender,age groups,and causes among children and adolescents in Yunnan Province during 2015 to 2019 were analyzed retrospectively.Poisson regression model was used to estimate the trend of mortality.Chi-square test was used to compare the differences of mortality by gender and age groups.Results During 2015 to 2019,the mortality rate of accidental injury in children and adolescents aged 5-19 years in Yunnan Province decreased from 19.15/10~5 in 2015 to 18.35/10~5 in 2019(Z=-3.36,P<0.01).The mortality rate of all types of accidental injuries in male was higher than that in female(χ^(2)=867.01,11.69,147.60,190.34,7.23,702.97,P<0.05).The top three causes of fatal accidental injuries included road traffic accidents,drowning and falls.Except for accidental falls,the mortality rate of other causes in the 15-19 age group was significantly higher than that in the age of 5-9 years and 10-14 years groups(χ^(2)=764.47,75.91,31.75,9.24,114.96,327.64,P<0.05).The top three traffic accidents were happened among motorcyclists,light trucks or caravans and cars,accounting for 27.83%,10.57%and 7.90%respectively.Conclusion Targeted measures should be taken continuously according to the characteristics of children and adolescents in different regions,age groups and gender to reduce the incidence and mortality of accidental injuries among children.