【作者】 杨江帆； 林春兰； 杨戎威； 李炜；

【Author】 YANG Jiang-fan, LIN Chun-lang YANG Rong-wei, et al JIAXING WOMEN AND CHILDREN ’S HOSPITAL, ZHEJIANG, CHINA 314000

【机构】 浙江嘉兴市妇幼保健院；

【摘要】 目的探讨嘉兴市妇幼保健院57292例围产新生儿中先天畸形的死亡变化规律和干预措施的成效。方法对1990年1月1日~2002年12月31日嘉兴市妇幼保健院出生的新生儿先天畸形死亡情况连续监测。干预措施研究包括:(1)调查和比较;创建NICU前后即1990年1月1日至1992年12月31日17283例围产新生儿和1993年1月1日至2002年12月31日40009例围产新生儿先天畸形病死专率。(2)调查和比较推广妇女增补叶酸前后:即1990年1月1日~1994年5月31日24463例围产新生儿和1994年6月1日~2002年12月31日32829例围产新生儿先天畸形病死专率。(3)调查和比较:采取以胎儿超声监测结合上述综合性干预措施前后即1990年1月1日~1992年12月31日17283例和2000年1月1日~2002年12月31日10925例围产新生儿先天畸形病死专率。结果57292例围产新生儿病死率4.47‰,先天畸形病死专率1.47‰,占围产新生儿死亡总数32.8%,死亡的前三位先天畸形分别为消化道畸形(35.7%)、先天性心脏病(28.6%)和神经管畸形(16.7%)。围产新生儿先天畸形病死专率比较:(1)创建NICU前为2.49‰,建立NICU后为1.02‰(X2=17.65P<0.001);(2)推广妇女增补叶酸前为2.29‰,推广妇女增补叶酸后为0.85‰(X2=19.75 P<0.001);(3)采取综合性干预措施前(1990~1992年)为2.49‰,采取综合性干预措施后的2000~2002年为0.18‰(X2=22.33 P<0.001)。结论:十年来嘉兴市妇幼保健院采取的降低围产新生儿先天畸形死亡的各项干预措施是科学的、有效的。更多还原

【Abstract】 Objective: To discuss alternation regulation and intervenemeasures’s effect of 57292 cases perinatal infant congenital malformationwere deliveried in JiaXing women and children s hospital.To discuss the death regularity of congenital malformation in 57292 perinatalinfants who were delivered in Jiaxing Women and Children s hospital and toobserve the intervene effect in these cases.Methods: Continous monitor death of newborn s with congenital malformationwho were deliveried in JiaXing women and children s hospital from Jan. 1, 1990to Dec. 31, 2002 . The study of intervene methods include: (1) Investigatingand comparing: perinatal infants congenital malformation fatality rate of 17283 cases from Jan.1,1990 to Dec. 31.1992 before NICU establishment and 40009 cases from Jan. 1,1993 to Dec. 31,2002 after NICU establishment. (2) Investigating and comparing perinatal infant congenital malformation fatality rate of 24463 cases from Jan. 1,1990 to Feb. 31,1994 before spreadwomen supplementing folic acid and 32829 cases from Jan. 1,1994 to Dec. 31, 2002 after spread women supplementing folic acid. (3) Investigating and comparing perinatal infant congenital malformation fatality rate of 17283 cases from Jan. 1,1990 to Dec. 31,1992 before taking comprehensive intervene methods and 10925 cases from Jan. 1,2000 to Dec.31,2002 after taking comprehensive intervene methods.Results: 57292 perinatal infant s fatality rate is 4. 47 ‰,congenital malformation’s fatality rate is 1. 47‰, totally death of perimatal infant is 32.8‰. The top three causes of congenital malformation are digestive tract malformation (35.7%). Congenital heart disease(28. 6 ‰)and neural take (tube?)defect(16.7%). Comparsion of perinatal infant congenital malformation’s fatality rate:(1)Before NICU establishment is 2.49‰,after NICU establishment is 1.02 % (X2=17. 65 P<0.001);(2)Before spread women supplementing folic acid is 2. 29‰,after spread women supplementing folic acid is 0.85‰5 (X2=19. 75 P<0. 001);(3)Before taking comprehensive intervene methods is 2. 49‰(1990-1992), after taking comprehensive intervene methods is 0.18‰ (2000-2002) (x2=22. 33 P<0. 001)Conclusion: During ten years ,each intervene method to reduce death of perinatal infant congenital melformation is scientific and effective更多还原