2014年-2020年某院住院新生儿病死率及死亡原因分析  

Analysis of Mortality and Cause of Death of Inpatient Neonates in a Hospital from 2014 to 2020

作　　者：刘祥英[1] 吴金星[1] 胡梅英[1] 黄文剑[1] 胡佳华 Liu Xiangying;Wu Jinxing;Hu Meiying;Huang Wenjian;Hu Jiahua(Jiangxi Provincial Children's Hospital,Nanchang 330006,Jiangxi Province,China;不详)

机构地区：[1]江西省儿童医院,江西省南昌市330006

出　　处：《中国病案》2021年第11期63-67,共5页Chinese Medical Record

基　　金：江西省卫生健康委员会科技计划项目(20195549)。

摘　　要：目的分析住院新生儿死亡原因及变化情况,为研究及制定降低新生儿病死率策略提供科学依据。方法收集2014年1月1日-2020年12月31日江西省某儿童专科医院住院新生儿的临床资料,分析胎龄、出生体重、性别、日龄、新生儿的病死率,并进行死亡原因分析。结果45874例住院新生儿死亡459例,病死率为1.00%,病死率从2014年的1.13%下降至2020年的0.67%。胎龄越小,出生体重越低,新生儿病死率越高(P<0.001)。其中,早产儿病死率为3.28%,足月儿病死率为0.62%;超低出生体重儿病死率为30.00%,正常出生体重儿病死率为0.60%。新生儿病死率男性高于女性(1.13%vs 0.79%,P<0.001)。459例死亡新生儿中生后1天~7天死亡347例,占75.6%,生后7天以上死亡112例,占24.4%。前3位主要死亡原因是新生儿感染、先天畸形及坏死性小肠结肠炎。新生儿感染是早产儿与低出生体重儿死亡的最主要原因,先天畸形是足月儿与正常体重儿死亡的最主要原因。坏死性小肠结肠炎在极早早产儿、早期早产儿中发生率较高,分别占死因的21.8%和18.2%。结论随着新生儿救治水平逐步提高,住院新生儿病死率呈下降趋势。加强围产期管理,控制新生儿感染是降低住院新生儿死亡的首要措施。Objective To analyze the causes and change trend of neonatal death in hospital from 2014 to 2020 in Jiangxi provincial,provide a scientific basis for reduction of infant mortality.Methods Clinical data of neonates hospitalized in a children's hospital in Jiangxi Province from January 1st,2014 to December 31st,2020 were collected to analyze the gestational age,birth weight,sex,day-age mortality and cause of death.Results There were 459 deaths among 45874 hospitalized neonates,and the case mortality rate was 1.00%.The mortality rate of hospitalized neonates decreased from 1.13% in 2014 to 0.67% in 2020.the lower gestational age and birth weight tended to have a higher mortality rate(P<0.001),and the mortality rates of preterm infants and full-term infants were 3.28% and 0.62%,the male infant mortality rate was higher than that of female infant(1.13%vs 0.79%,P<0.001).Among the 459 dead neonates,347(75.6%)died within 1-7 days,and 112(24.4%)died within 8-28 days.Top three causes of neonatal death were infection,congenital malformation,and necrotizing enterocolitis.Infection was the leading cause of death in premature and low birth weight infants,Congenital malformations were the leading cause of death in term and normal weight infants,The incidence of necrotizing enterocolitis was higher in very early infants and early premature infants,accounting for 21.8% and 18.2% of the deaths,respectively.Conclusions With the improvement of the level of neonatal treatment,the mortality rate of inpatient newborns was decreasing.Strengthening perinatal management and controlling neonatal infection were the primary measures to reduce neonatal death in hospital.

关 键 词：新生儿死亡 病死率 死亡原因 

分 类 号：R722.1[医药卫生—儿科]