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目的:了解恩施州5岁以下儿童主要死亡原因变化情况。方法:对2005~2011年恩施州8个县(市)5岁以下儿童4 658例死亡资料进行分析。结果:2005~2011年恩施州5岁以下儿童死亡率呈现逐年下降趋势。前五位死因依次为肺炎、早产和低出生体重、出生窒息、意外窒息、先天性心脏病。未治疗比例呈下降趋势,由2005年的43.1%下降到2011年的18.3%,住院治疗和门诊治疗所占比例分别由41.0%和15.9%增至64.0%和17.7%。因经济困难、交通不便来不及送医院家长认为病情不严重、风俗习惯及其他原因而导致死亡的分别占2.7%、3.1%、69.1%、14.5%、1.9%和8.7%。结论:加强母亲健康教育,提高产儿科质量,强化婴儿家庭安全教育,提高儿童家长医疗服务利用能力,是降低恩施州5岁以下儿童死亡率的关键措施。
OBJECTIVE: To understand the main causes of death among children under 5 in Enshi prefecture. Methods: The data of 4 658 deaths of children under 5 years old in 8 counties (cities) in Enshi from 2005 to 2011 were analyzed. Results: The mortality rate of children under 5 years of age in Enshi prefecture decreased year by year from 2005 to 2011. The top five causes of death were pneumonia, premature birth and low birth weight, birth asphyxia, accidental suffocation, congenital heart disease. The proportion of untreated patients showed a downward trend from 43.1% in 2005 to 18.3% in 2011, and the proportion of inpatient and inpatient treatment increased from 41.0% and 15.9% to 64.0% and 17.7% respectively. 2.7%, 3.1%, 69.1%, 14.5%, 1.9% and 8.7% respectively of the deaths due to financial difficulties and inconvenient transportation to the hospital parents who think the disease is not serious, customs and other reasons. Conclusions: Strengthening mother’s health education, improving the quality of pediatrics, strengthening infant family safety education, and improving the ability of parents to use medical services are the key measures to reduce the mortality rate of children under 5 in Enshi.