四川省2004年-2015年65952例病残儿医学鉴定疾病构成与顺位分析  

An analysis of diseases composition and cis position of 65952 disabled children who applied for medical authentication between 2004 and 2015 in Sichuan province

作　　者：赵君 张宏光 田爱平[2] 代巧云 杨莉[3] 彭左旗 袁燕[2] 李霞[4] 杨雪莹 马旭 

机构地区：[1]国家卫生计生委科学技术研究所,北京100081 [2]成都中医药大学,四川省人口和计划生育科学技术研究所 [3]四川省卫生和计划生育委员会 [4]四川大学华西第二医院

出　　处：《中国计划生育学杂志》2017年第11期744-750,共7页Chinese Journal of Family Planning

基　　金：国家重点研发计划(2016YFC1000307);国家人口与生殖健康科学数据中心(2005DKA32408)

摘　　要：目的:对病残儿医学鉴定资料进行疾病构成及顺位分析,为制定重点防治策略提供依据。方法:基于标准化的国际疾病分类(ICD-10)编码自动归类流程,对四川省2004年—2015年地市级医学鉴定的65 952例病残儿对应的76 726个鉴定诊断进行疾病编码,应用SPSS统计软件对12年间病残儿鉴定审批情况、基本人口学特征、疾病分类和总体顺位进行分析。结果:四川省20个市(州)2004年-2015年平均病残儿鉴定审批率为74.11%,鉴定时年龄(8.82±4.16)岁,男性病残儿占56.77%,农村病残儿占73.34%,性别比农村(146.29)高于城镇(98.29)。病残儿鉴定诊断共计849种疾病,前4类分别为先天性畸形、变形和染色体异常,神经系统疾病,眼和附器疾病,精神和行为障碍,所占比例分别为24.84%、17.87%、11.01%、10.96%。其中先天性畸形、变形和染色体异常又以循环系统(30.56%)、肌肉骨骼系统(23.57%)和生殖器官(10.58%)先天性畸形居多。居前10位疾病分别为癫痫(10.32%)、未特指的精神发育迟缓(6.61%)、大脑性瘫痪(4.47%)、屈光和调节疾患(4.30%)、心脏的其他先天性畸形(3.86%)、视觉障碍(3.80%)、心间隔先天性畸形(2.70%)、其他听觉丧失(2.13%)、脑的其他先天性畸形(1.84%)、头部损伤后遗症(1.26%)。结论:四川省病残儿医学鉴定中先天性畸形、变形和染色体异常最为常见,其中癫痫、精神发育迟缓、脑瘫、屈光和调节疾患、心脏先天性畸形是高发病种,需要针对这些重点疾病制定切实有效的防治对策,建立病残儿家庭登记及后续服务体系,有效管控高危家庭生育风险,提高出生人口素质。Objective： To analysis diseases composition and cis position of disabled children who applied for medical au- thentication, and to provide evidence for making priority preventing and cure strategies. Methods： Based on an utomat- ic classification process of standard ICD 10 diseases, 76726 diagnosed diseases corresponding to 65952 disabled children who applied for medical authentication at prefectural city level in Sichuan province were coded between 2004 and 2015. And the identification situation of approval disabled children, basic demographic characteristics, diseases classification, as well as overall cis position of these disabled children during 12 years were analyzed by SPSS statistics software. Re- sults： Average approval ratio of medical authentication of 20 prefectural city of Sichuan province between 2004 and 2015 was 74.11%, average age of disabled children when applied for medical authentication was 8.82 years old, male accounted for 56.77%, children from rural area accounted for 73.34%, sex ratio of rural area disabled children （146.29） was higher than those of disabled children from urban area （98.29）. 849 types of diseases were diagnosed by the authentication. Congenital malformations, deformations and chromosomal abnormalities （24.84 %）, diseases of the nervous system （17.87%）, diseases of the eye and adnexa （11.01%）, mental and behavioural disorders （10. 96%） were four major diseases categories. In congenital malformations, deformations and chromosomal abnormalities category, congenital malformation of circulatory system （30.56 % ）, musculoskeletal system （23.57%）, and genitourinary organs （10.58%） were major diseases. The top ten diseases were epilepsy （10.32%）, unspecified mental retardation （6.61%）, cerebral palsy （4.47%）, disorders of refraction and accommodation （4.30%）, other congenital malforma- tions of heart （3.86%）, visual disturbances （3.80 % ）, congenital malformations of heart septum （2.70 % ）, other hear- ing loss

关 键 词：病残儿 性别比 ICD-10 疾病构成 顺位分析 四川省 

分 类 号：D919.4[医药卫生—法医学]