太原市迎泽区围产儿出生缺陷影响因素研究及护理干预

发布时间：2018-05-17 07:12

本文选题：出生缺陷 + 影响因素　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:本研究通过调查太原市迎泽区2008~2015年围产儿出生缺陷监测资料,了解迎泽区出生缺陷的发生情况及变化趋势,采用1:1匹配病例对照研究方法,分析出生缺陷发生的影响因素,探讨针对性的护理干预对策,为出生缺陷的综合防治提供参考依据,以减少出生缺陷的发生,提高出生人口素质。方法:1.太原市迎泽区2008~2015年围产儿出生缺陷监测结果分析收集2008~2015年太原市迎泽区出生缺陷监测医院的监测资料,获得迎泽区八年间围产儿出生缺陷数据,包括围产儿出生总数、出生缺陷总数、出生缺陷种类和出生缺陷儿转归情况等,录入Excel表,建立数据库,运用发生率、构成比等简单统计学方法,分析迎泽区围产儿出生缺陷的发生情况及变化趋势。2.太原市迎泽区围产儿出生缺陷影响因素研究及护理干预采用1:1匹配病例对照研究方法,病例组和对照组相关资料从太原市妇幼保健综合管理平台获取,录入Excel表,建立数据库,采用SPSS19.0软件包进行单因素条件Logistic回归分析及多因素条件logistic回归分析,探讨影响出生缺陷发生的相关因素及护理干预效果。结果:1.太原市迎泽区2008~2015年围产儿出生缺陷监测结果分析(1)太原市迎泽区2008~2015年共监测围产儿56723例,其中出生缺陷儿853例,出生缺陷总发生率为150.38/万,全国围产儿出生缺陷总发生率为145.06/万,迎泽区围产儿出生缺陷发生率总体高于全国监测数据。从整体来看,2010~2012年为迎泽区出生缺陷发生的高峰期,2012~2014年出现波动,此后维持在较高水平。(2)迎泽区2008~2015年出生缺陷以先天性脑积水、多指(趾)、神经管畸形、外耳畸形及先天性心脏病为主。先天性心脏病的顺位不断上升,2015年跃居首位,与全国监测趋势保持一致;神经管缺陷的顺位已退出前五,但其防治形势依然严峻。2.太原市迎泽区围产儿出生缺陷影响因素研究及护理干预(1)多因素条件logistic回归分析显示:叶酸增补(OR=0.548)、产前检查(OR=0.320)为出生缺陷的保护因素,以往不良妊娠结局(OR=1.769)、父亲吸烟(OR=1.379)、妊娠合并症:妊娠期高血压疾病(OR=1.675)、妊娠期糖尿病(OR=2.013)、其他妊娠合并症(OR=1.590)为出生缺陷的危险因素。(2)影响出生缺陷发生的因素是多方面的,多因素条件logistic回归分析显示:围孕期积极增补叶酸,增加产前检查次数,养成良好生活习惯并注意妊娠期间患病情况是影响出生缺陷的重要因素,通过开设孕妇学校、设立产前咨询门诊、实施孕早期门诊咨询-产前检查-分娩全程健康教育的护理干预措施,增强孕产妇的自我保健意识、改善其不良生活方式,引导孕产妇形成正确的产前检查行为,减少不良结局的发生。结论:1.太原市迎泽区围产儿出生缺陷发生率总体处于较高水平,高于全国监测数据。出生缺陷以先天性脑积水、多指(趾)、神经管畸形、外耳畸形及先天性心脏病为主。2.叶酸增补和产前检查为出生缺陷的保护因素;以往不良妊娠结局、父亲吸烟及妊娠合并症为出生缺陷的危险因素。3.开设孕妇学校、设立产前咨询门诊、实施门诊-产检-分娩全程健康教育的护理干预措施,可以有效降低不良结局发生率。
[Abstract]:Objective: by investigating the birth defect monitoring data of perinatal infants in Yingze District of Taiyuan, this study is to understand the occurrence and trend of birth defects in Yingze District, and to analyze the influencing factors of birth defects by using 1:1 matched case-control study methods, and to discuss the pertinent nursing intervention strategies for the comprehensive prevention and treatment of birth defects. To provide reference basis to reduce the occurrence of birth defects and improve the quality of birth population. Methods: analysis of the monitoring results of perinatal birth defects in Yingze District, Taiyuan, 2008~2015, collected the monitoring data of the birth defect monitoring hospital in Yingze District of Taiyuan city in the year 2008~2015, and obtained the birth defect data of perinatal infants in Yingze District, including perinatal birth. The total number of birth, the total number of birth defects, the types of birth defects and the outcome of the birth defect children, the Excel table, the establishment of a database, the use of the incidence, the composition ratio, and other simple statistical methods, analysis of the occurrence and trend of birth defects in perinatal infants in Yingze District.2., the study and nursing of the factors affecting the birth defects of perinatal infants in Yingze District of Taiyuan The 1:1 matched case control study method was used. The related data of the case group and the control group were obtained from the comprehensive management platform of maternal and child health care in Taiyuan. The Excel table was recorded, the database was set up. The single factor conditional Logistic regression analysis and multi factor conditional logistic regression analysis were carried out by SPSS19.0 software package to discuss the phase affecting the birth defects. Results: 1. the results of the monitoring of the perinatal birth defects in Yingze District, Taiyuan, 2008~2015 (1) 56723 cases of perinatal infants were monitored in the Yingze District of Taiyuan, including 853 births, the total birth defect rate was 150.38/ million, the total incidence of birth defects in the national perinatal fetus was 145.06/ million, Yingze district. The incidence of birth defects in perinatal infants was generally higher than the national monitoring data. From the overall point of view, 2010~2012 was the peak period of birth defects in Yingze District, fluctuating in 2012~2014, and then maintained at a high level. (2) the birth defects in the Yingze district were congenital hydrocephalus, multi finger (toes), neural tube malformation, external ear malformation and congenital heart disease in 2008~2015 years. The leading position of congenital heart disease was increasing. In 2015, it was the first to be in the first place, consistent with the national monitoring trend; the position of neural tube defects had already dropped out of the first five, but the prevention and control situation was still severe in.2. Yingze District, Taiyuan City, the influence factors of perinatal birth defects and nursing intervention (1) multiple factor conditional analysis showed that: Folic acid supplementation (OR=0.548), prenatal examination (OR=0.320) as a protective factor for birth defects, previous adverse pregnancy outcomes (OR=1.769), father smoking (OR=1.379), pregnancy complication: pregnancy induced hypertension (OR=1.675), gestational diabetes (OR=2.013), and his pregnancy complication (OR=1.590) as a risk factor for birth defects. (2) influence birth defects. The factors that occur are multifaceted. Multiple factor conditional logistic regression analysis shows that active supplementation of folic acid in the perinatal period, increasing the number of antenatal examinations, forming good living habits and paying attention to the illness during pregnancy are important factors affecting birth defects. By setting up a pregnant school, setting up a prenatal consultation outpatient and implementing outpatient consultation in the early pregnancy - Prenatal examination - the nursing intervention measures of the whole course of health education, strengthen the self-health consciousness of the pregnant and parturant, improve their bad life style, guide the pregnant and parturant to form the correct prenatal examination behavior and reduce the occurrence of bad outcome. Conclusion: 1. the incidence of birth defects in the perinatal infants in Yingze District of Taiyuan is at a high level, which is higher than the national supervision. Data. Birth defects were congenital hydrocephalus, multi finger (toes), neural tube malformation, external ear malformation and congenital heart disease..2. folic acid supplementation and prenatal examination were protective factors for birth defects. Previous adverse pregnancy outcomes, father smoking and pregnancy complications were risk factors for birth defects.3., and prenatal counseling was set up. Outpatient service, out-patient delivery, whole childbirth health education intervention measures can effectively reduce the incidence of adverse outcomes.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.72

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