目的了解重庆市病残儿医学鉴定的相关情况。方法采用回顾性资料分析及问卷调查的方式对重庆市渝北区、沙坪坝区、万州区、长寿区、南川区、黔江区、綦江县、开县、忠县、垫江县、石柱县、北碚区、永川区、荣昌县、奉节县、秀山县、丰都县2003-2008年第一孩鉴定为病残儿并已审批同意生育第二孩的2684例家庭进行研究。结果在实际调查的2684例病残儿鉴定申请表中,有1503例项目漏填,占56%,有2013例填写不仔细,不能说明问题,占75%。有56例不是母子照片,占2.09%。病残儿童父母在申请病残儿童医学鉴定的条件和程序的知晓度都在80%以上,有85%以上的病残儿童父母都是从各级人口和计划生育行政和技术服务部门以及医疗卫生人员处获知病残儿童医学鉴定的有关事宜。已生育二胎2088例,占77.79%,第二胎患病的有9例,占0.43%.有92.51%的再生育父母得到再生育指导,有86.44%的再生育父母进行了孕前咨询。计生办对88.71%的再生育家庭建立了监测档案。2684例中回答产前检查的有2395例,其中2172例进行了产前检查,占80.92%,223例未进行产前检查,占8.31%,未回答289例,占10.77%。病残儿童父母对人口和计生部门服务的满意度,有97.65%回答的是满意或基本满意,没有对病残儿医学鉴定工作的信访案。结论实行区(县)初筛,市级终局鉴定,统一了鉴定标准,杜绝了人情鉴定,群众满意度高。再生育指导、孕前优生咨询、产前检查不尽科学、合理、规范,建卡的优生优育跟踪监测还没有完全覆盖,应加强和完善对区(县)人口计生部门有关人员的培训制度,严格鉴定程序,尽快建立科学、合理、规范的再生育优生技术管理服务体系。 Objective To understand the related situation of medical identification of disabled children in Chongqing. Methods By means of retrospective data analysis and questionnaire survey, the author made a comparative analysis of the data of Chongqing Yubei District, Shapingba District, Wanzhou District, Changshou District, Nanchuan District, Qianjiang District, Qijiang County, Kaixian County, Zhong County, Dianjiang County, Shizhu County and Beibei District , Yongchuan District, Rongchang County, Fengjie County, Xiushan County and Fengdu County. The first child from 2003 to 2008 was identified as disabled and examined and approved 2684 families who agreed to have their second child. Results Of the 2684 applications for the identification of disabled children actually surveyed, there were 1503 cases missing or filled in, accounting for 56%. There were 2013 cases that were not carefully filled out and could not explain the problem, accounting for 75%. There are 56 cases of mother and child photos, accounting for 2.09%. Parents of sick or disabled children are more than 80% aware of the conditions and procedures for applying for the medical assessment of children with disabilities. More than 85% of the parents of sick and disabled children are from all levels of population and family planning administrative and technical services as well as medical and health care Staff were informed of the medical identification of sick children related matters. There were 2088 cases of second births, accounting for 77.79%, and 9 cases of second sickness, accounting for 0.43% .There were 92.51% of the rebirth parents received rebirth guidance, and 86.44% of the fertile parents had counseling before pregnancy. Family Planning Office set up monitoring files on 88.71% of re-fertile families. Of the 2684 cases, 2395 were prenatal tests, of which 2172 were prenatal tests (80.92%), 223 were not prenatal tests (8.31%), and 289 (10.77%) were unanswered. 97.65% of satisfied parents or parents of disabled children were satisfied or basically satisfied with the services of population and family planning departments, and there was no petition letter for medical identification of disabled children. Conclusion The implementation of district (county) screening, municipal final appraisal, unification of the identification criteria, eliminate the identification of the human face, the masses satisfaction. Reproductive guidance, prenatal counseling, prenatal care is not scientific, reasonable, standardized, card birth eugenics monitoring has not been fully covered, should strengthen and improve the district (county) population and family planning departments of the relevant personnel training system, strict Identification procedures, establish a scientific, rational and standardized management system for reborn eugenics as soon as possible.