CAJ | 학술논문

目的分析梳理西安市2010至2012年新生儿死亡监测信息、评审结论和建议，总结新生儿死亡评审工作经验，以进一步完善新生儿死亡评审工作，降低新生儿死亡率。方法本研究回顾了3年来西安市新生儿死亡监测及市、区（县）级评审资料，对相关数据进行分析，研究新生儿死亡率、死因顺位、就诊地点的变化情况、规律、评审结论和建议。结果西安市新生儿死亡率3年来较为平稳的维持在2．90‰～2．29‰左右，死亡原因集中在早产和低出生体重、出生窒息、先天性心脏病、肺炎及其它先天异常，就诊级别集中在县级和县级以上医疗机构，区县级占60．34％、市级占80．77％的评审病例结论为创造条件可避免死亡或可避免死亡。2011年市级和区县级评审结果差异无统计学意义（ P＝0．241＞0．05）；2012年市级和区县级评审结果差异有统计学意义（P＝0．043＜0．05）。结论新生儿死亡评审可从更高层面和更广角度对新生儿死亡进行全面分析，从而找出新生儿死亡的影响因素，提出干预措施。正确认识评审意义，资料完整、专家共享，有条件可进行尸检是做好评审工作的重要因素，评审建议的充分应用更是评审的最终目的。
목적분석소리서안시2010지2012년신생인사망감측신식、평심결론화건의，총결신생인사망평심공작경험，이진일보완선신생인사망평심공작，강저신생인사망솔。방법본연구회고료3년래서안시신생인사망감측급시、구（현）급평심자료，대상관수거진행분석，연구신생인사망솔、사인순위、취진지점적변화정황、규률、평심결론화건의。결과서안시신생인사망솔3년래교위평은적유지재2．90‰～2．29‰좌우，사망원인집중재조산화저출생체중、출생질식、선천성심장병、폐염급기타선천이상，취진급별집중재현급화현급이상의료궤구，구현급점60．34％、시급점80．77％적평심병례결론위창조조건가피면사망혹가피면사망。2011년시급화구현급평심결과차이무통계학의의（ P＝0．241＞0．05）；2012년시급화구현급평심결과차이유통계학의의（P＝0．043＜0．05）。결론신생인사망평심가종경고층면화경엄각도대신생인사망진행전면분석，종이조출신생인사망적영향인소，제출간예조시。정학인식평심의의，자료완정、전가공향，유조건가진행시검시주호평심공작적중요인소，평심건의적충분응용경시평심적최종목적。
Objective To analyze the monitoring information , review conclusions and recommendations on neonatal death in Xi'an City from 2010 to 2012, and summarize the experiences of the neonatal death review , so as to further improve the neonatal death review and reduce the neonatal mortality rate .Methods The study reviewed the data of the neonatal death monitoring and death review during last three years.The relevant data was analyzed and the research on neonatal mortality , rank order of death causes , change of places where doctors were visited, review conclusions and suggestions were done by using the SPSS 13.0.Results The neonatal mortality rate in Xi'an city stably remained 2.90‰-2.29‰during last three years.The main causes of the neonatal death were premature , low birth weight, birth asphyxia, congenital heart disease , pneumonia and other congenital anomaly .The main level of treatment was county medical institutions or above.The conclusion of 60.34% of neonatal death in district ( county) level institutions and 80.77% in municipal institutions were avoided death by creating conditions or avoided death .No significance difference was found in 2011 municipal and district and county leveled appraisal results(P=0.241>0.05), but there was statistical significance difference in 2012 municipal and district and county leveled appraisal results(P =0.043 <0.05).Conclusion The neonatal death review could be used to analyze the neonatal death comprehensively on a higher and broader level , so that the influencing factors of neonatal death can be found and the interventions are proposed.Correct understanding of the significance of death review , complete data, expert sharing, as well as conditional autopsy are important factors to make the death review well .The full application of review suggestions is the final purpose of the neonatal death review .