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目的了解2012~2013年丹东市城乡5~19岁儿童青少年死亡的流行病学特征,为预防儿童青少年早死和制定相关防控策略提供科学依据。方法利用2012~2013年丹东市城市、农村死亡资料,采用国际疾病分类法(ICD-10)进行编码,计算死亡率、潜在减寿年数(Potential years of life lost,PYLL)和平均减寿年数(Average years of life lost,AYLL)等指标,分析导致儿童青少年死亡的主要原因。结果 2012~2013年丹东市5~19岁儿童青少年平均死亡率为19.68/10万,标化死亡率为18.98/10万,男女标化率比值为2.82(χ2=25.18,P<0.01)。前5位死因依次是损伤和中毒、肿瘤、循环系统疾病、神经系统疾病与传染病和寄生虫病,损伤和中毒的前2位死因依次是交通事故和淹死,占损伤和中毒总死亡的66.67%(40/60);肿瘤主要是白血病占35.71%(5/14),白血病城市高于农村(χ2=4.42,P<0.05)。主要死因PYLL前三位依次是损伤和中毒(3 610人年)、肿瘤(835人年)和循环系统疾病(590人年),占全部死因PYLL的77.97%。结论无论城市和农村,损伤和中毒都位于儿童青少年死因首位,其中交通事故是首因,应进一步加强交通管理控制;白血病是城市儿童青少年恶性肿瘤主要死因,应改善医疗保险条件和加强健康促进。
Objective To understand the epidemiological characteristics of adolescent mortality among children aged 5-19 years in urban and rural areas of Dandong City from 2012 to 2013 and to provide scientific evidence for prevention of premature death in children and adolescents. Methods The data of deaths in urban and rural areas of Dandong City from 2012 to 2013 were coded by International Classification of Diseases (ICD-10) to calculate the mortality, the PYLL and the average number of years of life lost Average years of life lost, AYLL) and other indicators to analyze the main causes of child and adolescent mortality. Results The average mortality of children aged 5-19 years old in Dandong was 19.68 / 100000 between 2012 and 2013. The standardized death rate was 18.98 / 100000. The ratio of male to female was 2.82 (χ2 = 25.18, P <0.01). The top five causes of death were injury and poisoning in turn. The top two causes of death from cancer, circulatory system diseases, nervous system diseases and infectious diseases and parasitic diseases, injuries and poisoning were traffic accidents and drownings in turn, accounting for the total deaths from injuries and poisonings 66.67% (40/60). The tumor mainly leukemia accounted for 35.71% (5/14), leukemia in urban area was higher than that in rural area (χ2 = 4.42, P <0.05). The top three leading causes of death were injury and poisoning (3 610 person-years), cancer (835 person-years) and circulatory disease (590 person-years), accounting for 77.97% of all causes of PYLL. Conclusion In both urban and rural areas, injury and poisoning are both the first cause of death among children and adolescents. Traffic accidents are the first cause and traffic control should be further strengthened. Leukemia is the leading cause of cancer among urban children and adolescents. Health insurance should be improved and health promotion should be improved.