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目的通过新生儿死亡评审及时发现并掌握各个环节中存在的问题,提出针对性的干预措施,为降低新生儿死亡率提供决策依据。方法根据《新疆维吾尔自治区级新生儿死亡评审管理办法》的规定,采用WHO“十二格表”评审方法分析2012—2013年新疆死亡的、上报材料完整的84例新生儿死亡材料。结果 2012—2013年新疆14个监测县(市、区)报告活产70 438例,新生儿死亡863例,新生儿死亡率12.26‰;其中本地户口842例,非本地户口21例;死于家中和途中新生儿305例、占35.34%,死于医疗机构内的新生儿558例、占64.66%;新生儿前5位主要死因为早产或低出生体重、出生窒息、肺炎、先天性心脏病、神经管畸形;死因构成最高的是早产或低出生体重,2012年死亡率69.12/10万、占48.04%,2013年死亡率55.23/10万、占45.08%;死亡评审材料完整并符合自治区级评审条件的84例新生儿中,2012年25例新生儿死亡病例中可避免死亡以及创造条件可避免死亡24例、占96.00%,2013年59例新生儿死亡病例中可避免死亡以及创造条件可避免死亡52例、占88.14%,2013年与2012年相比,死亡比例下降7.86%,差异无统计学意义(χ~2=1.26,P>0.05)。结论新生儿疾病、产科处理不到位、新生儿窒息复苏技能不足、新生儿死于复苏现场或转运途中、没有形成危重新生儿抢救合力和贫困是导致新生儿死亡的重要原因。
OBJECTIVE To find out and grasp the problems in all links in time through neonatal death assessment and put forward targeted interventions to provide decision-making basis for reducing the neonatal mortality rate. Methods According to the “Regulations of Xinjiang Uygur Autonomous Region for Neonatal Death Accreditation”, 84 death cases of newborns who died in Xinjiang in 2012-2013 and whose reported materials were complete were analyzed by WHO “Twelve Tables”. Results A total of 70 438 live births were reported in 14 monitoring counties (cities and districts) in Xinjiang from 2012 to 2013, with 863 neonatal deaths and neonatal deaths of 12.26 ‰, of which 842 were local and 21 were non-local ones. There were 305 newborns on the way, accounting for 35.34%, 558 newborns dying from medical institutions, accounting for 64.66% of all cases; the top 5 neonatal deaths were premature birth or low birth weight, birth asphyxia, pneumonia, congenital heart disease, Neural tube defects; the highest cause of death is premature birth or low birth weight, the death rate in 2012 was 69.12 / 100000, accounting for 48.04%, the death rate in 2013 was 55.23 / 100000, accounting for 45.08%; the death review material was complete and in line with the autonomous region-level review Of the 84 newborns with conditions that avoided death in 25 neonatal deaths in 2012 and conditions that avoided avoidable deaths in 24 cases (96.00%), avoidable deaths in 59 neonatal deaths in 2013 and the creation of conditions were avoidable There were 52 deaths, accounting for 88.14%. Compared with 2012, the death rate decreased by 7.86% in 2013 with no significant difference (χ ~ 2 = 1.26, P> 0.05). Conclusion neonatal diseases, obstetric treatment is not in place, neonatal asphyxia recovery skills, newborns died of resuscitation or transit, did not form a critical newborn rescue force and poverty is an important cause of neonatal deaths.