利用DALY指标分析我国新生儿窒息的疾病负担

目的 利用伤残调整生命年(disability adjusted life years, DALY)指标分析我国新生儿窒息的疾病负担, 为政府合理分配有限的卫生资源提供科学佐证。方法 通过文献检索整理我国新生儿窒息的发生率、死亡率和伤残率数据;采用专家德尔菲法获得我国新生儿窒息所导致的失能权重;依据以上数据资料, 计算新生儿窒息的DALY。结果 我国不同地区新生儿窒息的发生率在1.14%~11.7%之间;全国5岁以下儿童出生窒息死亡率为221.3/10⁵。0~17岁儿童智力残疾率为0.9%, 其中新生儿窒息为第三位致残原因, 占8.6%。0~6岁听力残疾的儿童中, 因新生儿窒息所致残疾占6.34%。新生儿窒息导致的失能权重为0.390。2010年我国5岁以下儿童新生儿窒息DALYs为8 241 093人年, 每千人口DALYs为109.1人年。若新生儿窒息发生率和死亡率同时下降10%, DALYs可下降9.73%。结论 新生儿窒息是导致我国儿童死亡和残疾的主要原因之一, 由出生窒息所引发的疾病负担是巨大的。推广新生儿复苏技术、降低出生窒息的发生率和死亡率具有良好的社会效益。

Study on disease burden of birth asphyxia in China using disability adjusted life years.

Objective Through analysing the disability adjusted life years (DALY) of birth asphyxia to provide rational planning of health resources distribution in China. Methods Literatures in 2010 were searched and reviewed to analysis the mortality, mobility and disability rate of birth asphyxia.The Delphi method was used to obtain data on the disable weight of each complication.Based on the data of literature review and Delphi research, the DALY of birth asphyxia was calculated. Results The incidence of birth asphyxia ranged from 1.14% to 11.7% in different provinces in China.The mortality rate of birth asphyxia among children under 5 years old was 221.3/10⁵.The intelligence disability rate among children aged 0~17 was 0.9% in 2010, with birth asphyxia being the third cause.Disability caused by birth asphyxia accounted for 6.34% of hearing disability among children aged 0~6.The disability weight of birth asphyxia was 0.390.Based on data of the sixth nationwide population census, DALYs caused by birth asphyxia of among children under 5 was 8 241 093 person year in the whole country, which was 109.1 person year per 1000 population.If birth asphyxia incidence and mortality decrease by 10% at the same time, there will be a 9.73% decrease in the DALYs. Conclusions Neonatal asphyxia is one of the major causes of child death in China.The disease burden caused by birth asphyxia is huge.Generalize neonatal resuscitation skills can decrease the incidence and mortality of birth asphyxia, which has significant social benefit.