Abstract: Objective To understand the current status and influencing factors of neonatal mortality in Shaanxi Province,to explore the problems of policy implementation,and to give suggestion on improvements and policies to reduce neonatal death. Method Data of the neonatal death monitoring and death review from 2010 to 2016 in Shaanxi Province were analyzed retrospectively. Results The neonatal mortality rate of Shaanxi province declined from 8.94‰ in 2010 to 3.87‰ in 2016.The rural decline rate (5.77‰) was greater than that of the city (1.8‰).The main causes of the neonatal death were premature/low birth weight,birth asphyxia,accidental suffocation,congenital heart disease,pneumonia and congenital anomaly.In 2010,2011 and 2013,birth asphyxia ranked in the first of the death causes;In 2012,congenital heart disease was the first; Since 2015,premature /low birth weight has been the first cause of neonatal death.A total of 66 cases were reviewed,11(16.7%) were inevitable death; 37(56.0%) were avoided death by creating conditions,18(27.3%)were avoided death. Conclusions Neonatal recovery skills training is suggested to be powered in order to minimize neonatal motality.And it is crucial to standardize the management of the premature and neonatal critical disease treatment technology and to establish the network of emergency transion in critical newborns.

Key words: death review, rank order of death cause, neonate

摘要： 目的 了解陕西省目前新生儿死亡现状及其影响因素,分析在新生儿危重症救治工作中存在的问题和薄弱环节,进而提出改进意见和建议,为制订相关政策提供理论依据。方法 以陕西省新生儿死亡评审为基础,依托5岁以下儿童死亡监测系统,分析新生儿死亡现状,研究自2010年开展新生儿死亡评审以来,新生儿死亡评审制度对新生儿死亡率的影响,并进行综合评价。结果 新生儿死亡数逐年下降,总死亡率由2010年的8.94‰下降至2016年的3.87‰,下降幅度为5.07‰,农村下降幅度(5.77‰)大于城市(1.8‰)。导致新生儿死亡常见的疾病为:出生窒息、肺炎、先天性心脏病、意外窒息、其他先天性异常、早产低出生体重。出生窒息为2010、2011、2013年的顺位第一,自2015年开始早产低出生体重为顺位第一,2012年顺位第一为先天性心脏病。7年间共评审病例66例,参评专家83人,其中11(16.7%) 例“不可避免”死亡;37(56.0%)例 “创造条件可避免”, 18(27.3%)例“可避免”死亡。结论 应加强化新生儿复苏技术培训以降低陕西省新生儿死亡率;重点开展早产儿救治技术、新生儿危重症识别及救治技术的培训;建立并规范全省范围内的危重新生儿转诊网络。

关键词: 死亡评审, 死亡顺位, 新生儿