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目的:了解和掌握甘肃省5岁以下儿童死亡率变化趋势及相关因素,探讨干预措施及效果。方法:对2001～2005年甘肃省妇幼保健三级保健网监测资料进行分析。结果:5年共监测活产婴儿74 137例,5岁以下儿童死亡1 456例,死亡率为19.64‰,其中新生儿死亡1 047例,新生儿死亡率为14.12‰,婴儿死亡率为17.56‰。5年来,新生儿死亡率、婴儿死亡率、5岁以下儿童死亡率均呈下降趋势。新生儿及婴儿死亡的主要原因是窒息、早产或低出生体重、肺炎及先天畸形;1～4岁儿童死亡主要原因是意外伤害、肺炎、先天畸形、脑膜炎;5岁以下儿童死亡的主要原因与婴儿相近。结论:降低5岁以下儿童死亡率重点是降低新生儿和婴儿死亡率;加强孕产期保健,提高住院分娩率及产儿科医务人员技术水平;孕前及孕早期服用小剂量叶酸,避免孕期接触致畸因子等,对降低5岁以下儿童死亡率具有重要意义。
Objective: To understand and master the trend of mortality of children under 5 years old in Gansu Province and related factors, to explore the intervention measures and effects. Methods: The monitoring data of three-level health care network of MCH in Gansu Province from 2001 to 2005 were analyzed. Results: A total of 74 137 live births were monitored in 5 years and 1 456 were under 5 years old with a mortality rate of 19.64 ‰, of which 1 047 were neonatal deaths, with a neonatal mortality rate of 14.12 ‰ and an infant mortality rate of 17.56 ‰ . In the past five years, neonatal mortality rate, infant mortality rate and child mortality rate under 5 years of age have shown a downward trend. The main causes of neonatal and infant deaths are asphyxia, premature birth or low birth weight, pneumonia and congenital malformations. The main causes of death among children aged 1 to 4 are accidental injuries, pneumonia, congenital malformations and meningitis; and deaths among children under 5 years of age Similar to baby. Conclusion: To reduce the mortality rate of children under 5 years old is to reduce the neonatal and infant mortality rate; to strengthen the maternity period health care, to enhance the hospital delivery rate and the technical level of the pediatric medical staff; to take a small dose of folic acid before and during the first trimester to avoid the contact during pregnancy It is of great importance to reduce the mortality of children under 5 years of age.