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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。
Objective To analyze the disease burden of neonatal asphyxia by disability adjusted life years (DALY) index in order to provide scientific evidence for the government to rationally allocate limited health resources. Methods The data of incidence, mortality and disability of neonatal asphyxia were collected and retrieved through literature search. The weight of disability caused by neonatal asphyxia in China was obtained by Delphi method. Based on the above data, the DALY of newborn asphyxia was calculated. Results The incidence of neonatal asphyxia in different regions of China was between 1.14% and 11.7%. The mortality rate of birth asphyxia among children under 5 years old was 221.3 / 105. The rate of mental disability was 0.9% in children aged from 0 to 17, of which neonatal asphyxia was The third cause of disability, accounting for 8.6%. Children aged 0 ~ 6 years with hearing disabilities accounted for 6.34% of the total number of children with disabilities due to neonatal asphyxia. The weight of disability caused by neonatal asphyxia is 0 390. In 2010, the number of newborns with asphyxia DALYs in our country was 8,241,093 person-years and the number of DALYs per 1,000 population was 109.1 person-years. DALYs may decrease by 9.73% if both neonatal asphyxia and death rates drop by 10% at the same time. Conclusions Asphyxia of newborns is one of the major causes of child mortality and disability in China. The burden of disease caused by birth asphyxia is enormous. The promotion of neonatal resuscitation technology to reduce the incidence of birth asphyxia and mortality has good social benefits.