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目的:掌握全市5岁以下儿童死亡变化趋势及死因构成,为降低5岁以下儿童和婴儿死亡率提出干预措施。方法:回顾性调查无锡市2001～2011年5岁以下儿童死因与构成,并对在三级医院死前治疗的儿童死亡评审病例进行分析。结果:5岁以下儿童死亡率逐年下降,2011年比2001年下降了57.61%,11年来5岁以下儿童总死亡率为6.36‰,婴儿总死亡率为4.62‰,新生儿死亡率为3.21‰,主要以新生儿死亡为主。累计死因顺位前5位依次是早产低体重、溺水、先天性心脏病、出生窒息、肺炎。死因类别顺位前3位依次是新生儿疾病、出生缺陷、意外和中毒。死亡评审结果:可避免或创造条件可避免死亡占24.00%,死因主要以家属态度、知识技能和资源为主而放弃治疗。结论:巩固孕产妇保健和儿童保健基础工作,加强人员培训和质量监管,重视健康教育,降低儿童死亡率。
OBJECTIVE: To grasp the trends of death and the causes of death in children under 5 in the city, and to provide interventions to reduce the mortality rate of children and infants below 5 years of age. Methods: The causes of death and constitution of children under 5 years of age in Wuxi from 2001 to 2011 were retrospectively analyzed. And the death cases of children who were treated before death in tertiary hospitals were analyzed. Results: The mortality rate of children under 5 years of age decreased year by year, down by 57.61% from that of 2001. The total death rate of children under 5 years old was 6.36 ‰ in 2011, the total infant mortality rate was 4.62 ‰, the neonatal mortality rate was 3.21 ‰, The main neonatal deaths. The top 5 cumulative causes of death were premature birth, low birth weight, drowning, congenital heart disease, birth asphyxia and pneumonia. The top three causes of death causes were neonatal diseases, birth defects, accidents and poisoning. Death assessment results: to avoid or create conditions to avoid deaths accounted for 24.00%, the cause of death mainly to family members attitude, knowledge and skills and resources to give up treatment. Conclusion: To consolidate the basic work of maternal and child health care, strengthen personnel training and quality control, attach importance to health education and reduce child mortality.