本文關(guān)鍵詞：德州市2011-2015年居民死因監(jiān)測結(jié)果與疾病負(fù)擔(dān)分析　出處：《山東大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 死亡率 標(biāo)化死亡率 死因順位 期望壽命

【摘要】：研究背景近年來,伴隨著經(jīng)濟(jì)快速的發(fā)展、社會(huì)環(huán)境不斷的變化以及居民生活方式的悄然改變,居民疾病譜和死亡譜也發(fā)生了相應(yīng)變化,由心血管疾病、腦血管疾病、糖尿病、惡性腫瘤等慢性非傳染性疾病引起的死亡所占比例不斷增加。死因監(jiān)測的數(shù)據(jù)作為合理配置衛(wèi)生資源的一項(xiàng)基礎(chǔ)性資料,對(duì)評(píng)價(jià)某個(gè)地區(qū)居民總體健康水平具有非常重要作用,而對(duì)死因數(shù)據(jù)進(jìn)行的系統(tǒng)分析是反映居民健康水平的重要內(nèi)容之一,可以獲得一個(gè)地區(qū)居民的病傷死亡水平、死亡原因及變化趨勢,為疾病預(yù)防控制工作明確優(yōu)先方向,為制定衛(wèi)生策略和措施提供科學(xué)依據(jù)。德州市于2005年在武城縣啟動(dòng)了以死因監(jiān)測為主要內(nèi)容的疾病監(jiān)測試點(diǎn)工作,是山東省省級(jí)疾病監(jiān)測網(wǎng)的組成部分,到2011年德州市死因監(jiān)測工作擴(kuò)大到了全市11縣市區(qū)。從2012年開始,德州市疾控中心加強(qiáng)對(duì)縣市區(qū)死因監(jiān)測工作的培訓(xùn)和督導(dǎo),確保了死因監(jiān)測數(shù)據(jù)的數(shù)量和質(zhì)量逐年提高。本研究對(duì)2011-2015年山東省德州市死因監(jiān)測數(shù)據(jù)進(jìn)行分析,了解影響德州市居民健康和壽命的主要疾病及其危害程度,尋找影響德州市居民健康的主要衛(wèi)生問題,為衛(wèi)生行政部門制定針對(duì)性的政策提供參考依據(jù)。研究目的了解2011-2015年5年間德州市居民死亡水平、主要死亡原因及變化趨勢,尋找影響德州市居民健康的主要衛(wèi)生問題,為制定有針對(duì)性的疾病預(yù)防控制策略提供相應(yīng)的政策依據(jù)。資料與方法按照死亡日期為1月1日至12月31日、戶籍地址德州、已審核等條件,由中國疾病預(yù)防控制中心死因登記報(bào)告系統(tǒng)導(dǎo)出2011、2012、2013、2014、2015年數(shù)據(jù),人口數(shù)據(jù)來自國家統(tǒng)計(jì)局。采用國際疾病分類ICD-10進(jìn)行根本死因編碼。采用2010年全國人口普查數(shù)據(jù)計(jì)算標(biāo)化死亡率。采用Excel2007和SPSS18.0軟件對(duì)數(shù)據(jù)進(jìn)行整理和分析,采用描述性統(tǒng)計(jì)方法計(jì)算粗死亡率、標(biāo)化死亡率、死亡構(gòu)成比、死因順位等指標(biāo)。研究結(jié)果2011-2015年德州市總?cè)丝?28330982,其中男性14385561人,女性13945421人,男女性別相對(duì)比1.03:1,與2000年山東省人口普查數(shù)據(jù)相比,兒童負(fù)擔(dān)系數(shù)下降明顯,老年人負(fù)擔(dān)系數(shù)上升。通過對(duì)五年間死因數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析可以得到:(1)德州市2011-2015年總?cè)巳捍炙劳雎?10.62/10萬,標(biāo)化死亡率為428.10/10萬,男性與女性相比,無論是粗死亡還是標(biāo)化死亡率,男性均高于女性;(2)2011-2015年德州市居民前五位死因依次為心腦血管疾病(粗死亡率363.70/10萬,構(gòu)成比59.56%)、惡性腫瘤(粗死亡率115.76/10萬,構(gòu)成比18.96%)、損傷和中毒(粗死亡率36.85/10萬,構(gòu)成比6.04%)、呼吸系統(tǒng)疾病(粗死亡率28.09/10萬,構(gòu)成比4.60%)和消化系統(tǒng)疾病(粗死亡率12.06/10萬,構(gòu)成比1.98%),前五位死因共占總死因的91.14%;(3)2011-2015年德州市因惡性腫瘤死亡的人群中死因順位前五位的依次是肺癌(粗死亡率22.41/10萬)、胃癌(粗死亡率17.47/10萬)、肝癌(粗死亡率12.01/10萬)、食管癌(粗死亡率7.87/10萬)和結(jié)直腸癌(粗死亡率4.04/10萬);(4)德州市2011-2015年人均期望壽命為78.45歲,其中男性76.13歲,女性80.94歲。結(jié)論與對(duì)策建議研究分析結(jié)果顯示,德州市總?cè)巳簶?biāo)化死亡率高于全國第三次死因調(diào)查的結(jié)果,在全省各地級(jí)市中位于倒數(shù),死因監(jiān)測工作仍存在大量漏報(bào);慢性病導(dǎo)致的死亡占總死亡的89.74%,儼然成為導(dǎo)致德州市總?cè)巳核劳龅淖钪饕ｋU(xiǎn)因素;由于地區(qū)環(huán)境、人群生活方式和習(xí)慣、人口比例等因素影響,三大類疾病各占的比例與山東省同期相比略有差別;前五位死因順位與山東省全省及省內(nèi)其他地級(jí)市的死因順位有一定差異,這也體現(xiàn)出了死因順位具有地區(qū)差異的特性。建議:(1)加強(qiáng)群眾對(duì)慢性非傳染性疾病主要危險(xiǎn)因素的認(rèn)識(shí),大力提倡禁煙限酒、健康飲食習(xí)慣和科學(xué)適當(dāng)?shù)捏w育鍛煉等健康生活方式;(2)疾病控制關(guān)口前移,深入研究心腦血管疾病、惡性腫瘤、損傷和中毒等主要死因的環(huán)境和社會(huì)因素,對(duì)危害因素進(jìn)行動(dòng)態(tài)監(jiān)測;(3)落實(shí)好基本公共衛(wèi)生項(xiàng)目,建立健全居民健康檔案,做好老年人定期體檢和高血壓、糖尿病人的隨訪;(4)進(jìn)一步強(qiáng)化德州市死因監(jiān)測工作,減少漏報(bào),提高報(bào)告質(zhì)量。
[Abstract]:Background: in recent years, with the rapid economic development, the social environment changes and lifestyle changes quietly, residents of disease and death spectrum is also changed, from cardiovascular disease, cerebrovascular disease, diabetes, chronic non communicable diseases such as malignant tumor death caused by increasing the proportion of death. The monitoring data as a basic data for the rational allocation of health resources, has a very important effect on the evaluation of the overall health of an area residents, system analysis of cause of death data is one of the important contents reflect the health level of residents, residents can obtain a region of the death level, death causes and trends for disease prevention and control work, clear priorities, and provide scientific basis for the formulation of health strategies and measures. The city of Dezhou on 2005 in Wucheng county to start The cause of death monitoring as the main content of the disease monitoring pilot work is part of the Shandong provincial disease surveillance network, Dezhou city in 2011 to monitor the cause of death was extended to the city's 11 counties. From the beginning of 2012, the Dezhou Municipal Center for disease control to strengthen the training and supervision of the counties of death monitoring work, ensure the quality and quantity of death monitoring data the increased year by year. By the analysis of 2011-2015 in Shandong Province, Dezhou City death monitoring data, the main diseases and damage to understand the impact of health and life of the residents of Dezhou City, Dezhou city for the major health problems in people's health, to provide reference and basis for the policy for health administrative departments to investigate the 2011-2015 formulation. The level of death 5 years residents of Dezhou City, the main causes of death and change trend for the major health problems in Dezhou city for residents' health. To develop targeted disease prevention and control strategies to provide policy basis. Materials and methods from January 1st to December 31st according to the date of death, Dezhou has registered address, audit and other conditions, by Chinese Center for Disease Control and prevention of the death registration reporting system derived from 20112012201320142015 data, population data from the National Bureau of statistics. Using the international classification of diseases of ICD-10 root the cause of death. Encoding standardized mortality rate calculated using the 2010 national census data. The data were collected and analyzed using Excel2007 and SPSS18.0 software, using descriptive statistical method to calculate the crude mortality, standardized mortality rate, constituent ratio of death, mortality and other indicators. The results of 2011-2015 years of Dezhou City, the total population of 28330982, including 14385561 men. 13945421 female, male and female sex ratio relative to 1.03:1, compared with the 2000 census data of Shandong Province, children The burden coefficient decreased significantly, rising elderly burden coefficient. Through statistical analysis can be obtained in the five years of data on cause of death: (1) 610.62/10 2011-2015 crude mortality rate of the total population of Dezhou City million, the standardized mortality rate was 428.10/10 million, compared to men and women, either death or crude standardized mortality rate, men are higher than women; (2) Dezhou city residents 2011-2015 years ago, five major causes of death were cerebrovascular diseases (the crude mortality rate of 363.70/10 million, accounting for 59.56%), malignant tumor (crude mortality rate of 115.76/10 million, accounting for 18.96%), injury and poisoning (the crude mortality rate of 36.85/10 million, accounting for 6.04%), respiratory diseases (the crude mortality rate of 28.09/10 million the constituent ratio of 4.60%), and digestive system disease (the crude mortality rate of 12.06/10 million, accounting for 1.98%), the five leading causes of death of 91.14% of the total; (3) 2011-2015 in Dezhou city because of the mortality of malignant tumors and death among the top five Of lung cancer (the crude mortality rate of 22.41/10 million (17.47/10), gastric cancer mortality, liver cancer (000) the crude mortality rate of 12.01/10 million), esophageal cancer (mortality 7.87/10 million) and colorectal cancer (mortality 4.04/10 million); (4) 2011-2015 in Dezhou City, life expectancy is 78.45 years old, male 76.13 years old, female 80.94 years old. The conclusion and Countermeasures Research and analysis results showed that the total population of Dezhou City, the standardized mortality rate is higher than the third national mortality survey in the whole province in the countdown, death monitoring work there are still a large number of missing report; chronic disease deaths accounted for 89.74% of the total deaths, has become the leading the risk of death in the total population of Dezhou city; due to the regional environment, life style and habits of people, the proportion of the population impact factors, three kinds of disease and the proportion of Shandong province is slightly different compared to the same period; top five causes of death And the province of Shandong province and other cities of deathin have certain difference, this also reflects the rank with regional difference characteristics. Suggestions: (1) to strengthen public awareness of the major risk factors for chronic non communicable diseases, advocating smoking alcohol limit, healthy eating habits and proper sports science exercise and other healthy lifestyle; (2) the sooner the disease control, in-depth study of cardiovascular and cerebrovascular diseases, malignant tumor, main causes of injury and poisoning of the environmental and social factors, dynamic monitoring of harmful factors; (3) the implementation of basic public health programs, establish and improve the residents' health records, regular physical examination and do the elderly hypertension, diabetes patients follow-up; (4) to further strengthen the Dezhou death monitoring work, reduce the false negative rate, improve the quality of reports.

【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R195

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