论文部分内容阅读
目的:分析儿童专科医院5年到院死亡病例的原因、影响因素及趋势，为有效减少儿童到院死亡提供数据支持及策略指导。方法:收集2015年1月至2019年12月5年间上海市儿童医院急诊接诊的到院死亡病例，分别对死亡儿童的性别、年龄、籍贯、死亡季节、死亡时段及可能的死亡原因进行分析，研究儿童到院死亡病例的相关特征。结果:共收集到院死亡病例151例，年份分布上呈逐年递减，性别上男童多于女童，年龄以1岁以内婴儿为主，外地籍贯多于上海户籍，差异均有统计学意义(n P0.05)。在推测死亡原因方面：围生期疾病占33.8%(51/151)，伴严重基础疾病占39.1%(59/151)，明确意外因素占14.6%(22/151)，不明原因死亡占12.6%(19/151)，分布差异有统计学意义(n χ2＝32.497，n P<0.001)；同时伴明确基础疾病的到院死亡病例在性别、年龄的分布差异有统计学意义(n χ2＝4.898，n P＝0.027；n χ2＝32.169，n P<0.001)；意外伤害所致的到院死亡病例在年份、年龄的分布差异有统计学意义(n χ2＝16.636，n P＝0.002；n χ2＝14.727，n P＝0.002)。n 结论:做好围生期保健及筛查，减少早产及出生缺陷，积极宣教减少儿童意外伤害，普及医疗急救知识，加强儿童转运系统，是未来减少儿童到院死亡的有效策略。“,”Objective:To analyze the causes, influencing factors and trends of dead on arrival cases in children′s Hospital in the past 5 years, aiming to provide direction and basis for reducing the dead on arrival cases of children.Methods:We collected the dead on arrival cases in the department of emergency at Shanghai Children′s Hospital from January 2015 to December 2019, classifed and analysed the gender, age, native place, death season, time of death, and possible causes of death, and then studied the correlation between above factors and the cases.Results:A total of 151 dead on arrival cases were collected.The annual number decreased year by year, and boys were more than girls in gender.Most of them were infants under 1 year old, and nonlocal children were more than Shanghai native.The above differences were statistically significant, but there was no significant difference in the distribution of death season and death time.In terms of the cause of death, perinatal diseases accounting for 33.8%(51/151), those accompanied with severe underlying diseases accounting for 39.1%(59/151), accidental death accounting for 14.6%(22/151), unexplained deaths accounting for 12.6%(19/151). Those distribution differences were statistically significant(n χ2=32.497, n P<0.001). Meanwhile, there were statistic differences in gender and age of the cases with severe underlying diseases(n χ2=4.898, n P=0.027; n χ2=32.169, n P<0.001), and the year and age distributions of the accidental death cases also had significant differences(n χ2=16.636, n P=0.002; n χ2=14.727, n P=0.002).n Conclusion:To reduce dead on arrival cases of children, we should do a good job in perinatal health care and screening, reduce premature birth and birth defects, actively conduct propaganda to prevent children′s accidental injuries, popularize medical first aid knowledge, and strengthen children′s transport system.