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目的了解成都市5岁以下儿童意外死亡的现状和特点,为制定降低和控制5岁以下儿童死亡率政策提供依据。方法采用回顾性分析对2005-2014年成都市儿童意外死亡监测资料进行分析。结果 5岁以下儿童各年龄组总死亡率均呈下降趋势(P<0.05),下降最明显的是新生儿死亡率和28d以上婴儿死亡率。1~4岁儿童死亡率的下降趋势和意外死亡率各年龄组下降趋势均不明显。同时,5岁以下儿童意外死亡占总体死亡的比例呈上升趋势(χ2=4.50,P=0.03)。从意外死亡原因来看,新生儿期和大于28d婴儿意外死亡的主要原因是意外窒息(分别占88.37%和83.85%),1~4岁儿童意外死亡主要死因是溺水和交通意外(分别占58.16%和16.51%)。城乡比较,城市意外死亡无下降趋势(P>0.05),而农村意外死亡有下降趋势(P<0.05).且城乡间主要死亡原因顺位不同。城市前三位是意外窒息(38.48%),溺水(22.49%)和交通意外(15.44%);农村前三位是溺水(41.45%),意外窒息(33.79%),交通意外(12.08%)。结论控制和降低儿童意外伤害的死亡将是下一步降低儿童死亡的重要工作内容,应根据地区的环境特点、儿童年龄特点,加强对家长的健康宣教及建立和完善意外伤害的社会急救体系等干预措施,最大限度的降低儿童因意外造成的死亡,提高儿童的生存水平。
Objective To understand the current situation and characteristics of accidental death of children under 5 in Chengdu and to provide evidence for the development of a policy to reduce and control the mortality of children under 5 years of age. Methods A retrospective analysis was conducted on the data of accidental death monitoring of children in Chengdu in 2005-2014. Results The total mortality of children under 5 years of age showed a decreasing trend (P <0.05). The most obvious decrease was neonatal mortality rate and infant mortality rate above 28 days. The downward trend in mortality rate and the accidental mortality rate in children aged 1 to 4 years are not obvious in all age groups. At the same time, the proportion of unintended deaths to total deaths among children under 5 years showed an upward trend (χ2 = 4.50, P = 0.03). Accidental death was the major cause of unintentional death in infants and infants older than 28 days (88.37% and 83.85%, respectively). The main causes of accidental death among children aged 1-4 were drowning and traffic accidents (58.16 % And 16.51%). Compared with urban and rural areas, there was no downward trend in urban accidental death (P> 0.05), while the accidental death in rural areas showed a downward trend (P <0.05), and the main causes of death in urban and rural areas were in different order. The top three cities were asphyxial (38.48%), drowning (22.49%) and traffic accidents (15.44%). The top three in rural areas were drowning (41.45%), accidental suffocation (33.79%) and traffic accidents (12.08%). CONCLUSIONS: Controlling and reducing the death of child accidental injury will be the next important step in reducing child mortality. Intervention should be based on the characteristics of the environment, the age characteristics of children, strengthening the health education of parents and establishing and improving the social emergency system for accidental injuries Measures to minimize the death of children due to accidents, improve children’s living standards.