广州市5岁以下儿童2001-2010年意外死亡趋势流行病学分析

摘要

目的 了解广州市5岁以下儿童意外伤害死亡的变化趋势及流行病学分布特点.方法 分析2001-2010年广州市5岁以下儿童监测网死亡报告资料,描述意外伤害死亡水平、主要死因以及流行病学分布.结果 2001-2010年广州市5岁以下儿童意外伤害死亡水平呈逐年下降趋势.与2001年相比,2010年0岁组、1-4岁组、5岁以下儿童意外死亡率下降幅度分别为72.02％、77.17％和74.66％,差异有统计学意义(P＝0.000).10年间儿童溺水、交通意外、意外窒息、跌落死亡率均呈下降趋势(P＝0.000),其中溺水、意外窒息下降幅度最为明显.意外死因构成,0岁组主要为意外 窒息,1～2岁组主要为溺水,3岁组以交通意外和中毒为主,4岁组以交通意外和意外跌落为主.意外死亡主要集中发生在花都、从化、增城、番禺、南沙等C类地区,占广州区域儿童伤害发生构成的75.69％.结论 广州市儿童意外死亡降低的主要贡献来自于溺水、意外窒息干预.有侧重的将干预倾向于城郊、县级市等经济发展欠佳、人口流动性较大的区域的家长及儿童,是今后降低致死性伤害发生的关键.%Objective To study the trend of accidental death among children under 5 years of age.Methods A survey on accidental death among children was performed in Guangzhou to compare the data from the national monitoring program on the deaths under five in the same period during 2001-2010.Data on mortality and causes of injures were adjusted by missing reports.Results Mortality rates on injuries were decreasing annually from 2001 to 2010.Comparing with 2001,the magnitude of the drop in mortality among the 0,1-4 and under 5 year groups were 72.02％,77.17％ and 74.66％ respectively,with statistically significant differences (P＝0.000).During the 10 years of observation,data showed a dropping trend (P＝0.000) of the mortalitics on drowning,traffic accident,suffocation and falling,especially on drowning and suffocation.The main causes of death were suffocation in the 0 year group,drowning in the 1-2-year group,traffic accident and poisoning in the 3-year group,traffic accident and falling in the 4-year group.The accidental deaths happened in ‘C area’ which including Huadu,Conghua,Zengcheng,Panyu and Nansha,with the total proportion of accidental death in Guangzhou as 75.69％.Conclusion The mortality of accidental deaths among children under 5 years of age in Guangzhou had been decreasing during 2001-2010,mainly owing to the practice of intervention programs on drowning and suffocation,suggesting the necessity of integrating the health education programs on accidental injury with the healthcare management system in children in the country,focusing on the suburban and county levels where economy was relatively undeveloped or with more floating population.