广西90年代初居民中毒死亡分析

目的：为了解广西居民中毒死亡的一些流行病学行征。方法：用“STATA”软件包对1990-1992年广西十分之一人口全死因回顾调查资料进行分析。结果：中毒死亡率15.98/10万男15.34/10万）,占全死因死亡的2.66%（男2.30%,女3.16%),中位死亡年龄35.47岁（男40.00岁,女30.92岁）。毒物以非药用物质为主,占中毒死亡的88.17%。主要死亡原因依次为服农药自杀,酒精饮料意外中毒和有毒动植物致毒死亡。结论：中毒死亡是广西居民死亡的主要原因之一。     

Estimation of physiologic ability and surgical stress (E-PASS) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery

(Received for publication on Oct. 25, 1997; accepted on July 7, 1998)     

Using data from studies of health-related quality of life to describe clinical issues Examples from a longitudinal study of patients with advanced stages of cervical cancer

The focus of the paper is to describe how to present data from studies on health-related quality of life (H-QoL) in a way that is simple and clinically relevant. Data from a longitudinal study of patients with advanced stages of cervix cancer are used. One hundred and eighteen patients filled out questionnaires (including EORTC QLQ-C30) 7 times over a period of 2 years. The following issues are considered: (1) The use of a panel for an initial overview of data. (2) The visual difference between using mean and median values. (3) Box-whisker plots to illustrate the variability of the data. (4) The effect of combining categorical data into fewer categories. (5) Individual patient profiles showing the wide variability among patients. (6) A table showing the change of scores over a one-year period. (7) “Prognostic plots” dividing the initial scores and the following scores. (8) Plotting changes over time. (9) Illustration of the impact of non-random drop-out. (10) The effect of drop-out for the patients who fill out two sequential assessments. (11) The use of healthy controls to help answer the question “what is normal?”.     

电解铝厂职工恶性肿瘤死亡状况回顾性队列研究

对某电解铝厂职工恶性肿瘤死亡情况进行了１０年回顾性队列研究,以宁夏１９９０￣１９９２年人口年龄死亡专率为参比,计算了观察队列标化死亡比（ＳＭＲ）、癌症比例死亡比（ＰＭＲ和ＰＣＭＲ）,观察组肺癌超出量尤为显著,ＳＭＲ为１９０（Ｐ〈０．０１）,ＰＣＭＲ为１７１（Ｐ〈０．０５）。     

Perinatal mortality trends in a referral hospital

A comparative study of perinatal mortality patterns over a period was conducted at a teaching hospital of South India. Among the 6,048 babies born from January 1984 to December 1985 (Group A), there were 265 (43.8/1000) still births and 127 (22.0/1000) early neonatal deaths. Three hundred and thirty seven (41/1000) babies were still born and 235 (29.8/1000) early neonatal deaths out of 8,215 deliveries during 1992–93 (Group B). The perinatal mortality rate (PMR) in Group A and B were 57.9/1000 and 57.7/1000 respectively. Unbooked cases accounted for the majority (> 75%) of perinatal deaths during both the periods. The overall mortality rates in unbooked cases were three to four times higher than booked cases. Among the various causes of still births, antepartum haemorrhage and uterine rupture had increased. Septicaemia was the major cause of early neonatal deaths in Group A, but in Group B birth asphyxia and prematurity were the leading causes. Effective interventions like creating awareness among the target population to utilise maternal and child health services and early referral of high risk cases with improved intranatal and perinatal care can decrease the perinatal mortality.     

Early neonatal mortality in an intramural birth cohort at a tertiary care hospital

Early neonatal mortality (ENM) occurring among 12,283 consecutive live birthsover a period of 3 years were analysed. The early neonatal mortality rate (ENMR) was 26.6/1000 live births. Birth weight less than 2,000 gm, lack of antenatal care, male sex, operative vaginal delivery, prematurity and multiple pregnancy were significantly associated with early neonatal deaths. Birth asphyxia was found to be the most important cause of death, followed by hyaline membrane disease and congenital malformations. Majority of the asphyxia related deaths were due to late intrapartum referral of the mothers. Forty-two per cent of early neonatal deaths occurred in babies weighing less than 1,500 gm. Early identification and referral of high risk mothers and health education would significantly reduce the early neonatal deaths.     

Under fives mortality in the urban slums of Lucknow

The main objective of this study was to elicit proportional cause specific mortality in the underfives in the urban slums of Lucknow in North India. The families with under five mortality in the 28 randomly selected slums in 1993 were located from the records of the slum health workers and verbal autopsy was conducted to assign a cause of death. There were 71 deaths among 2796 children. The annual under five mortality was 25.4 and the under five mortality rate was 126.7. After the neonatal period, “high fever” that could not be classified into any other disease incorporated in the verbal autopsy instrument, was the most common symptom associated with death, seen in 21.1% cases (95% C.I.: 15.5–34.4%) followed by these diseases: pheumonia in 19.7%, diarrhea in 18.3% and measles in 11.4%. “High fever” as the leading symptom associated with death is being reported for the first time from the urban slums of India. There is an urgent need to identify the underlying etiologies of death due to “high fever” and the policy implications are that children with fever must receive immediate and continued medical attention till the symptom persists.     

Anaesthetic management of acute blunt thoracic trauma

Sunnybrook Health Science Centre is an adult regional trauma unit serving metropolitan Toronto and environs. We undertook a nvo-year retrospective review of patients admitted to our institution with blunt thoracic trauma. Three hundred and thirty-three patients with blunt trauma and an injury severity score (ISS) greater than 17 required emergency surgery. Of these, 208 had blunt thoracic injuries while 125 did not have chest injuries. Both groups were similar with respect to age but patients with thoracic trauma had a greater ISS. (P < 0.05) and greater intraoperative mortality (P < 0.01). The aetiology of the intraoperative deaths with one exception was exsanguination. Emergency thoracotomy or sternotomy indicated a poor prognosis with a mortality rate of 80%. The most common intraoperative problem was an elevated airway pressure. Awake intubation was undertaken in 77.5% of patients requiring anaesthesia and surgery because of the potentially compromised airways and difficult intubations due to the nature of the associated injuries. Finally, 74% of patients undergoing urgent surgery required mechanical postoperative ventilation. The presence of blunt chest trauma should be considered a marker of the severity of injury sustained by the patient.     

10年间剖宫产率及指征变化与围生儿死亡率的关系

目的：探讨剖宫产率及剖宫产指征变迁对围生儿死亡率的影响。方法：对10年间剖宫产病例资料进行回顾性分析。结果：1992－1996年剖宫产率为36．50％，显著低于1997－2001年的47．78％，两者比较，差异有极显著性（P＜0．01）。在剖宫产指征中，妊娠并发（合并）症始终处于第1位，社会因素上升为第2位，难产为第3位，胎儿窘迫为第4位。围生儿死亡率1992－1996年为17．88‰，1997-2001年为22．23‰，两者比较，差异无显著性（P＞0．05）。结论：剖宫产率升高在一定范围内降低了围生儿死亡率，但随着剖宫产率的进一步升高，围生儿死亡率并未随之下降。因此，应合理掌握剖宫产指征，降低剖宫产率。