2003-2012年住院新生儿死亡病例分析

目的：总结本院新生儿科近10年住院患儿病死率及死因构成，以进一步提高医疗水平，降低新生儿住院病死率。方法：回顾性分析2003-2012年住院新生儿病例资料，并分为2003—2007年和2008—2012年两个时间段进行分析比较。结果：10年间共收治新生儿22078例，其中死亡167例，平均住院病死率为0．76％，近5年较前5年有明显下降（0．53％ vs 1．05％，P=-0．000）；感染、先天性心脏病、早产及相关疾病是近10年住院新生儿的前3位死因（分别占28．74％、20．96％和15．57％），新生儿窒息引起的死亡位于第5位（占8．99％），意外引起的死亡近10年共有8例，位于死因第6位；近5年，先天性心脏病取代感染成为住院新生儿首要死因，感染在死因中的构成比有明显下降（36．0％ vs 17．9％，F=0．011）。结论：近年来新生儿住院病死率稳步下降，在抗感染治疗、出生窒息复苏方面取得重要成效；加强健康教育和普及产前检查，提高新生儿相关外科手术水平是今后降低本科室新生儿住院病死率的主要方向。

Analysis on the dead cases of hospitalized neonate from 2003 to 2012

Objective： To improve the medical level and cut the neonate in-hospital mortality by summarizing the death rate and the main causes of intra-hospital neonatal death. Methods： The medical records of intrahospital death newborns in our neonatology department from 2003 to 2012 were surveyed. The data were divided into two parts （2003-2007 and 2008-2012） and analyzed. Results： A total of 22 078 cases were admitted to neonatology admission department, including 167 death cases, with an average mortality rate of 0.76% in the past ten years. The average in-hospital mortality in 2008-2012 was lower than that in 2003-2007 （0.53% vs 1.05%, P=0.000）. Infection, congenital heart disease, premature birth and related diseases were the top three cause of death in the in-hospital neonate in 2003-2012 （28.74%, 20.96% and 15.57%, respectively）. Neonatal asphyxia was the fifth cause of death （8.99%） and 8 cases died from accidental injury in the past ten years. The congenital heart disease replaced the infection became the first in-hospital death cause in the past five years. The constituent ratio of infection in death decreased significantly （36.0% vs 17.9%, P=0.011）. Conclusion： In recent years, the inhospital mortality decreased in our neonatology department. The treatment of infection and neonatal asphyxia had been improved significantly. Enhancing the health education in pregnant woman, strengthening the antenatal examination, and improving the medical levels of neonatal surgery are the main direction of decreasing the inhospital mortality in our neonatology department.