陕西农村5岁以下儿童意外死亡的流行特征及影响因素分析  

The epidemiological features and relational factors of accidental death among children under 5 years of age in rural Shaanxi Province

作　　者：杨雪 王宝珠 甘露 李敏 于西萍 张娟 YANG Xue;WANG Baozhu;GAN Lu;LI Min;YU Xiping;ZHANG Juan(Department of Health,Northwest Women and Children’s Hospital,Xi’an 710061,China)

机构地区：[1]西北妇女儿童医院保健部,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2023年第3期489-492,F0003,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省重点研发计划项目(No.2018SF-246)。

摘　　要：目的了解陕西省5岁以下儿童意外窒息、溺水和交通意外死亡的主要特征,并探讨儿童意外死亡的相关影响因素。方法本研究采用病例对照的研究方法收集陕西省9个国家级监测区县中的5岁以下儿童意外死亡资料及对照组儿童资料。运用《全国5岁以下儿童常见意外伤害调查表》了解儿童的基本情况、家庭情况、看护情况、伤害发生情况。采用均数和标准差(x±s)以及百分数对儿童意外死亡基本情况进行描述,运用卡方检验和非条件Logistic回归分析的统计学方法,探讨儿童意外死亡发生的相关影响因素。结果在25名5岁以下意外死亡儿童中,交通意外有5例(20.0%),溺水有9例(36.0%),意外窒息有11例(44.0%)。从年龄分布看,因意外窒息死亡的儿童年龄较小,有90.9%在1岁以下(10例)。从性别分布看,交通意外死亡者均为男童。在意外伤害发生时,有8名儿童的看护人未在现场,而在现场的17例看护人中,仅有4名在看护儿童。死亡组进行过体检的儿童有16名(64%),少于对照组的25名(100%),两组差异有统计学意义(χ^(2)=8.672,P=0.003)。死亡组儿童主要看护人为母亲的有9名,少于对照组的14名,非条件Logistic回归分析结果显示,母亲为主要看护人的儿童死亡发生风险较父亲为主要看护人的儿童低(OR=0.016,95%CI:0.0003~0.997,P=0.049)。结论将儿童健康体检、养护行为指导以及针对性健康教育纳入常规的妇幼保健管理工作中,有助于降低5岁以下儿童意外伤害的发生率和死亡率。Objective To explore the epidemiological features and relational factors of accidental death among children under 5 years of age in rural area of Shaanxi Province.Methods A case-control study was conducted in the research,and children under 5 years old in nine National surveillance counties of Shaanxi were collected.The questionnaire of national survey of accidental injuries among children under 5 years of age was used to investigate the basic information of children,socio-demographic characteristics,child care status,injury occurrence condition.The mean,standard deviation and percentage were used to describe the basic situation and main characteristics of accidental death.The Chi-square test and Logistic regression methods were performed to explore the relational factors of accidental death of children.Results Of the 25 cases of accidental death of children under the age of five years old,5 were traffic accidents(20.0%),9 cases were falling(36.0%),and 11 were suffocation(44.0%).Age distribution showed that children of accidental suffocation were younger,with 90.9%(10 cases)of them under the age of 1 years old.Gender distribution showed that traffic accident deaths occurred to boys.Area distribution showed that falling and suffocation death mainly happened in Hanzhong,while traffic accidents death mainly in Weinan.When the accident happened,8 caregivers were not on the scene.What was worse,among 17 caregivers who were on the scene of accident,only 4 kept an eye on children.Compared with 25 children in control group,16 in case group had received health examination,and the difference showed statistical significance(χ^(2)=8.672,P=0.003).Meanwhile,9 main caregivers were mothers in the case group,compared with 14 in the control group.The Logistic regression analysis showed that compared with fathers,mothers as the children’main caregivers could positively reduce accidental death of children(OR=0.016,95%CI:0.0003-0.997,P=0.049).Conclusion To decrease the incidence rate and mortality of accidental death of children u

关 键 词：儿童 意外死亡 交通意外 溺水 意外窒息 影响因素 

分 类 号：R174.6[医药卫生—妇幼卫生保健]