某儿童专科医院近14年住院死亡病例统计分析  

Statistical Analysis of Hospitalized Death Cases in a Children's Hospital during 14 Years

作　　者：方敬 许姜姜[1] 

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院,上海市200062

出　　处：《中国病案》2018年第2期81-85,共5页Chinese Medical Record

摘　　要：目的通过统计分析住院患儿死亡病例的死因构成及死亡疾病谱的变迁,为降低儿童病死率、制订相应的儿童卫生保健政策及疾病防治措施提供科学依据。方法回顾性分析近14年某儿童专科医院的死亡患儿病案资料,包括一般情况、病死率及死亡疾病谱等。结果住院患儿病死率为0.42%(1144/271145)。死亡病例中,男女患儿分别为707(61.8%)和437(38.2%)例;婴儿期(<1岁)的死亡构成比最高(42.0%),其次是新生儿期(≤28天)(31.0%)。患儿死因前4位的疾病分别是:新生儿疾病(27.1%)、心血管系统疾病(13.7%)、感染性疾病(11.6%)及呼吸系统疾病(10.6%)。前7年感染性疾病的死因构成比远高于后7年(17.8%vs 9.3%),恶性肿瘤的死因构成比则远低于后7年(2.2%vs 6.3%),差异均具有统计学意义(均P<0.01)。败血症和肺炎在各年龄段住院儿童中均占死因构成前5位。结论降低住院患儿的病死率,需做好有效的围产期保健工作;提高环保意识以及加强环境污染治理;加强抗菌药物的管理,从而促进临床抗菌药物的合理应用。Objective To analyze causes of death and the disease spectrum changes of hospitalized death cases, and so as to provide a scientific basis for reducing the child mortality rate and developing appropriate child health care policies and disease prevention and control measures. Methods Medical records of hospitalized death cases in a children＇s hospital during 14 years, including the general situation, mortality and death disease spectrum, were retrospectively analyzed. Results The mortality rate of hospitalized children was 0.42%（1144/271145）. Among the deaths, there were 707（61.8%） boys and 437（38.2%） girls; infants（1 year） had the highest mortality（42.0%）, followed by neonatal（≤ 28 days）（31.0%）. The first four causes of death were neonatal disease（27.1%）, cardiovascular disease（13.7%）, infectious disease（11.6%）and respiratory disease（10.6%）. The death rate of infectious diseases of hospitalized children during 2003-2009 was much higher than that during 2010-2016（17.8% vs 9.3%）, while the death rate of malignancies was much lower（2.2% vs 6.3%）. The differences above were statistically significant（all P0.05）. Septicemia and pneumonia in all age groups of hospitalized children accounted for the top five causes of death. Conclusion To reduce the mortality of hospitalized children, the following three points should be done： effective perinatal health care work; improving environmental awareness and strengthening environmental pollution control; and strengthening the management of antimicrobial drugs, so as to promote the rational application of clinical antimicrobial drugs.

关 键 词：住院儿童 病死率 死因 败血症 肺炎 

分 类 号：R197.5[医药卫生—卫生事业管理]