2003-2009年北京市部分医院住院儿童疾病谱及病死原因演变

摘要

Objective To analyze the evolution of disease composition and causes of death in hospitalized children in hospitals of urban Beijing.Methods Medical data of 151 336 hospitalized children in Beijing Children's Hospital and the Sino-Japanese Friendship Hospital aged 0 ～ 18 years from 2003 to 2009 were analyzed to summarize changes of disease composition and mortality of each age group and year.According to international nosology ICD-10 classification criteria,first diagnosis of each child was classified into five catogeries:communicable diseases,non-communicable diseases,perinatal diseases,injuries and others.Results The first three diseases of hospitalized children were respiratory infection,congenital malformation and neonatal disease; the top five single diseases for hospitalization were pneumonia,inguinal hernia,cancer,upper respiratory tract infection and allergic purpura.The top three cause-specific death of hospitalized children were congenital heart disease,cancer and pneumonia.Congenital heart disease was the first cause of death in infants under the age of 1 year,while cancer as the first cause of death in more than 1 year old children.The top five diseases of hospitalized children were different in each age group.Conclusion The number of congenital malformations and cancer has significantly increased in hospitalized children in the hospitals of urban Beijing,but pneumonia still accouns for the most common disease in these children.Congenital heart disease is the first cause of death in infants,while cancer in more than 1 year old children,which is basically the same in developed countries.%目的 了解北京市部分医院住院儿童疾病构成和病死原因分布的变化.方法 回顾性分析2003-2009年北京儿童医院及中日友好医院儿科≤18岁住院24h以上151 336例病历资料.按年度、5个年龄段进行疾病构成和病死率的比较,同时将住院患儿的第一诊断按照国际疾病ICD-10分类标准化为感染性疾病、非感染性疾病、围生期疾病、伤害及其他5大类,按年度进行疾病和病死原因分布的比较.结果 住院患儿前三位系统疾病依次为:呼吸道感染、先天畸形、新生儿疾病.前五位单病种疾病依次为:肺炎、腹股沟疝、恶性肿瘤、上呼吸道感染、过敏性紫癜；前三位病死原因依次为:先天性心脏病、恶性肿瘤、肺炎,其中婴儿以先天性心脏病为首位病死原因,1岁以上儿童以恶性肿瘤为首位病死原因.各期儿童住院的前五位疾病各有不同.结论 北京城区医院住院儿童先天畸形、肿瘤等非感染性疾病明显增加,但仍以肺炎为首；婴儿以先天性心脏病为首位病死原因,1岁以上儿童以恶性肿瘤为首,与发达国家的病死原因一致.