2012-2016年住院新生儿死亡率及死因分析

摘要

Objective To analyze the clinical characteristics ,causes of death and their changes of hospitalized neonates so as to provide theoretical basis for improving the level of intensive medical care and reduce neonatal mortality .Methods The clinical data of 108 neonates who died between January 2012 and December 2016 were collected .We compared the mortality rate of neonates with different gestational age ,birth weight ,sex ,family background and abnormal high-risk pregnancy .The causes of death and death rate were analyzed .Results Among the 8869 hospitalized neonates ,108 died and the mortality rate of the neonates was 1 .22% .The avoidable mortality rate of the neonates was 0 .86% and the avoidable mortality ratio was 71 .29% .Infectious diseases remained to be the leading cause of neonatal death in hospitals . The top five most common causes of death in our hospitalized neonates were infectious diseases ,respiratory diseases ,asphyxia ,congenital malformations ,and genetic metabolic diseases .The three most common causes of death in full-term infants were infectious diseases ,genetic metabolic diseases ,and asphyxia . The three most common causes of death in preterm infants were infectious diseases , respiratory diseases ,and asphyxia .The neonatal mortality rate in our hospital decreased from 2 .02% in 2012 to 1 .09% in 2016 .Sepsis was the leading cause of death between 2012 and 2015 and dropped to the third place in 2016 . Respiratory diseases were the leading cause of death in 2016 . Asphyxia was the second cause of death in 2016 . Congenital malformations dropped from the third cause of death to the fifth .Conclusion In recent years ,thetreatment of neonates has improved and mortality rate of hospitalized neonates is gradually decreased .Controlling infectious diseases should be the primary measure to reduce the avoidable mortality in hospitalized neonates .%目的 分析住院死亡新生儿的临床特点、死因构成及变化规律,为提高围产重症医学救治水平,降低新生儿死亡率提供理论依据.方法 收集2012年1月至2016年12月住院新生儿的临床资料,探讨不同胎龄、出生体质量、性别、出生家庭、高危妊娠与新生儿死亡率的关系,总结死亡率、死因及变化规律.结果 ①8869例住院新生儿中死亡108例,死亡率1.22%,可避免死亡率0.86%;可避免死亡比71.29%.②感染性疾病仍然是住院新生儿死亡的首位原因.2012-2016年,我院住院新生儿前5位死因依次是:感染性疾病、呼吸系统疾病、窒息、先天畸形、遗传代谢性疾病.足月儿前3位死因分别为感染性疾病、遗传代谢性疾病、窒息.早产儿前3位死因分别为感染性疾病、呼吸系统疾病、窒息.③我院新生儿死亡率由2012年2.02%下降至2016年1.09%.败血症由2012-2015年间首位死因,下降至2016年第3位;呼吸系统疾病为2016年首位死因,窒息为第2位;先天畸形由前3位死因下降至5位以后.结论 随着新生儿救治水平逐步提高,住院新生儿死亡率呈下降趋势.控制感染性疾病是降低住院新生儿可避免死亡率的首要措施.