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目的了解5岁以下儿童死亡变化趋势与特点,探讨干预对策。方法收集1999-2008年临安市5岁以下儿童死亡监测资料,分析10年来5岁以下儿童死亡情况、死因顺位和死前就诊情况。结果2008年与1999年相比,新生儿死亡率下降了64.41%、婴儿死亡率下降了58.81%、5岁以下儿童死亡率下降了53.48%。男性儿童死亡率高于女性儿童,农村死亡率显著高于城市;新生儿死亡率占婴儿死亡的64.70%～88.00%,婴儿死亡率占5岁以下儿童死亡64.52%～86.21%。5岁以下儿童死因前五位为意外事故、先天性畸形、先天性心脏病、早产儿和低体重儿、出生时窒息和产伤。结论5岁以下儿童死因中意外事故和先天性畸形列第一、二位,因此应加强婚前、孕期保健,产前筛查和新生儿疾病筛查等,减少因出生缺陷导致的死亡。同时,加强全社会的健康教育,提高安全防范意识,开展预防意外伤害抢救的技术培训,降低意外事故造成的死亡,从而进一步降低儿童死亡率。
Objective To understand the trends and characteristics of death among children under 5 years of age and to explore intervention strategies. Methods The data on the death of children under 5 years of age in Lin’an from 1999 to 2008 were collected to analyze the deaths of children under 5 years old, Results Compared with 1999, the neonatal mortality rate dropped by 64.41% in 2008, the infant mortality rate dropped by 58.81%, and the death rate of children under 5 years decreased by 53.48%. The male child mortality rate is higher than that of female children, the rural mortality rate is significantly higher than the city; neonatal mortality rate accounted for 64.70% ~ 88.00% of infant deaths, infant mortality rate accounted for 64.52% ~ 86.21% of children under 5 years of age. The top five causes of death among children under 5 years of age were accidents, congenital malformations, congenital heart disease, premature births and low birth weight infants, asphyxia and birth trauma at birth. Conclusions The number of accidents and congenital anomalies among the under-five children under the age of five ranks first and second. Therefore, we should strengthen premarital and prenatal care, prenatal screening and neonatal screening to reduce the death caused by birth defects. At the same time, strengthening the health education of the entire society, raising the awareness of safety precautions, conducting technical training on emergency accident prevention and rescue, and reducing the death caused by accidents so as to further reduce the child mortality rate.