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本文对深圳市1990～1997年因独生子女先天残疾通过病残儿鉴定再生育二孩的家庭进行调查,并以同期通过鉴定的后天性残疾家庭为内对照,以农村地区一孩先天残疾未经病残儿鉴定生育二孩的家庭为外对照,了解其二孩先天残疾再发情况,尤其是同类病的再发情况,拟对独生子女病残儿医学鉴定和二胎生育指标的审批工作效果进行评价,为优生工作提供依据。研究结果表明,鉴定组一孩先天残疾家庭二孩先天残疾的患病率为5.81％,与广州市1986～1991年情况类似(5.9％),高于外省(辽宁1990～1992年为1.35％)。鉴定组二胎同类病发生率为2.8％,非鉴定组为4.55％,两组比较虽无统计学差异,但病种上却有不同,鉴定组为再发风险低的血友病、先天性共转性内斜视、脑萎缩,而非鉴定组为再发风险高的先天聋哑、进行性肌萎缩。提示病残儿鉴定工作颇有成效,避免了相当一部分遗传病家庭再次生育残疾儿,但某些环节有待进一步完善;对农村一胎先天残疾家庭生育二胎也必须纳入管理范围。
In this paper, we investigated the families of two children who were born in Shenzhen from 1990 to 1997 after one child was born with a disability through the identification of disabled children. In the same period, the congenital disability family was identified as an internal control, Disabled children identified fertile second child family as external control to understand the second child with congenital disability recurrence, especially the recurrence of similar diseases, the proposed childbearing sick child medical identification and second-child reproductive indicators of the approval work Evaluation, to provide the basis for eugenics. The results showed that the prevalence of congenital disability of two children with congenital disability family was 5.81%, which was similar to that of Guangzhou from 1986 to 1991 (5.9%) and higher than that of other provinces (1.35% from 1990 to 1992 in Liaoning Province) . The incidence of second-of-a-kind congenital diseases was 2.8% in the identification group and 4.55% in the non-identified group. Although there was no significant difference between the two groups, there was a difference in the types of the disease. The identification group was hemophilia with low recurrence risk, Trans-esotropia, cerebral atrophy, non-identified group of high risk of recurrent deafness, progressive muscular atrophy. Prompted the identification of disabled children quite fruitful, to avoid a considerable part of genetic disease family fertility again disabled children, but some aspects of the need to be further improved; rural one-birth-disabled congenital disability families must also be included in the scope of management of the second child.