长春市某医院649例新生儿新生儿毒性红斑患病现状及影响因素研究

发布时间：2018-06-28 18:13

本文选题：新生儿毒性红斑 + 发病率　；参考：《吉林大学》2013年硕士论文

【摘要】：新生儿毒性红斑又称新生儿中毒性红斑、新生儿过敏性红斑，简称新生儿红斑，是新生儿期常见病，发病率约30%~70%。国内关于新生儿红斑的报道较少，大多停留在对产妇生产前后的环境因素和新生儿初始状态的个别因素上，指导临床工作的实践意义不足。本次研究拟调查在我院生产的产妇及所产新生儿，通过问卷调查及血生化指标检查，描述新生儿红斑患病现状，探讨其可能的影响因素，并提出相应的护理建议，为不同类型产妇及所产新生儿提供预防新生儿红斑的参考。目的：了解长春市妇产医院产科新生儿红斑发病率、分布特征和影响因素，进而提出新生儿红斑的预防和护理的对策及建议。方法：本研究以2012年8月至2013年7月在吉林省长春市某妇产医院某疗区出生的新生儿为研究对象，根据2010年《实用新生儿学》新生儿毒性红斑的诊断标准诊断新生儿红斑。采用自行编制信息表调查产妇的人口学信息、产妇孕期生活习惯、既往病史、分娩方式、血生化指标等，同时调查婴儿基本信息、新生儿红斑情况等相关信息。数据采用EpiData建立数据库并进行数据平行双录入，用SPSS19.0统计软件进行描述性统计、卡方检验组间比较和影响因素的logistic分析统计分析。结果： 1.调查结果显示该医院新生儿毒性红斑发病率为56.70%(368/649)，男性新生儿的发病率为55.29%，女性新生儿的发病率为58.18%，不同性别新生儿红斑发病率差异无统计学意义(χ2=0.55，p=0.458)。 2.368例患病新生儿中出生当天发病占19.84%；出生后第一天占57.61%；出生后第二天占22.01%；出生后第三天占0.54%；单纯发生在面部占患病新生儿总数25.54%；单纯发生在躯干部占34.24%；单纯发生在四肢占27.72%；发生在面部和躯干部占1.90%；发生在躯干部和四肢占0.54%；发生在其他部位占10.05%。 3.影响因素单因素分析结果显示新生儿中毒性红斑与产妇年龄、产妇文化程度、新生儿体重、新生儿Apgar评分、孕期食用猪牛羊肉及禽类频率、平均一周内产妇家中使用电磁炉、微波炉、电吹风等电器情况、孕次、有无人工流产史、有无糖尿病、孕前月经周期、分娩方式、产前窘迫史、甘油三酯、总胆固醇和低密度脂蛋白等17个因素有关(P0.05)，与民族、家庭人均收入、新生儿性别、新生儿窒息史、吸烟、饮酒、饮食是否规律、其他既往病史及分娩因素等30个因素无关(P0.05)。 4.以新生儿是否患新生儿红斑作为因变量，将单因素分析中P0.10的因素作为自变量，引入多因素Logistic回归模型，采用多因素非条件逐步回归分析的方法进行多因素分析，分析结果显示模型拟合良好(χ2=93.538，P0.001)，共有7个因素最终进入方程，分别是总胆固醇、糖尿病史、产前窘迫史、Apgar评分、产妇文化程度、平均一周内产妇家中使用电磁炉、微波炉、电吹风等电器情况，产妇孕前月经血量。其中总胆固醇、产前窘迫史、产妇文化程度、平均一周内产妇家中使用电磁炉、微波炉、电吹风等电器情况，产妇孕前月经血量是危险因素(OR1，P0.05)，糖尿病史、Apgar评分是保护因素(OR1，P0.05)。结论： 1.新生儿红斑发病率较高，男女新生儿新生儿红斑发病率无差异。 2.多因素分析结果显示产妇文化程度，产妇孕期一周内家中使用电磁炉、微波炉、电吹风等电器情况，产妇糖尿病史，产妇孕前月经血量，产妇产前窘迫史，产妇总胆固醇水平，新生儿Apgar评分都为新生儿中毒性红斑的影响因素。总胆固醇、产前窘迫史、产妇文化程度、平均一周内产妇家中使用电磁炉、微波炉、电吹风等电器情况，产妇孕前月经血量是危险因素，糖尿病史、Apgar评分是保护因素。 3.应对产妇进行孕前、产前教育，保证其孕期营养均衡，并尽量避免可能的危险因素，提高产妇的生理、心理适应能力，，进而做到优生优育。
[Abstract]:Neonatal toxic erythema is also called neonatal toxic erythema, neonatal allergic erythema, abbreviated as neonatal erythema, is a common disease in newborns. There are few reports about the incidence of neonatal erythema in 30%~70%. domestic. Most of them stay on the environmental factors before and after the production of women and the initial state of new children, and guide clinical work. The purpose of this study is to investigate the status of neonatal erythematous disease by questionnaire survey and blood biochemical indexes, and to discuss the possible influencing factors of neonatal erythema, and to provide relevant nursing advice for the prevention of red spot of newborns for different types of women and newborns. Exam.
Objective: to understand the incidence, distribution characteristics and influencing factors of neonatal erythema in the obstetric department of Changchun Obstetrics and Gynecology Hospital, and to put forward the countermeasures and suggestions for the prevention and nursing of neonatal erythema.
Methods: in this study, the newborns born in a medical district of a maternity hospital in Changchun, Jilin province from August 2012 to July 2013 were studied. According to the diagnostic criteria of neonatal toxicity red spot in 2010, the neonatal erythema was diagnosed. The demographic information of the pregnant women and the living habits of pregnant women were investigated by a self-made information table. Previous medical history, delivery mode, blood biochemical index and so on. At the same time, the basic information of the baby and the situation of the newborn erythema were investigated. The data were set up by EpiData to establish the database and carried out the data in parallel double entry. The descriptive statistics were carried out with the SPSS19.0 statistical software, the comparison of the chi square test group and the logistic analysis and statistical analysis of the influencing factors.
Result:
1. the results of the survey showed that the incidence of neonatal toxic erythema was 56.70% (368/649), the incidence of male newborn was 55.29%, the incidence of female newborns was 58.18%. There was no significant difference in the incidence of erythema in different sex newborns (x 2=0.55, p=0.458).
The incidence of birth day in 2.368 cases was 19.84%, 57.61% on the first day after birth, 22.01% in second days after birth, 0.54% in third days after birth, 25.54% in the total number of newborns on the face, 34.24% in the body and four limbs, 27.72% in four limbs, and cadres in the face and body occupied 1. .90%; accounted for 0.54% of the trunk and limbs; 10.05%. occurred in other parts.
3. the results of single factor analysis showed that the newborn poisoned erythema and the maternal age, the maternal culture, the weight of the newborn, the Apgar score of the newborn, the frequency of beef and mutton and fowl in the pregnancy, the electric electromagnetic furnace, the microwave oven, the electric hair dryer and so on in one week. Before pregnancy, the menstrual cycle, the way of delivery, the history of prenatal distress, triglyceride, total cholesterol and low density lipoprotein were related to 17 factors (P0.05), which were not related to the 30 factors such as national, family per capita income, newborn sex, neonatal asphyxia history, smoking, drinking, diet regularity, and his previous history and delivery factors, and so on (P0.05).
4. according to whether neonatal erythema as a dependent variable, the factors of P0.10 in single factor analysis are taken as independent variables, multi factor Logistic regression model is introduced, and multi factor unconditional stepwise regression analysis is used to carry out multi factor analysis. The results show that the model is well fitted (x 2=93.538, P0.001), and there are 7 factors in the final entry. The equation, the total cholesterol, diabetes history, the history of prenatal distress, Apgar score, the maternal cultural level, the average maternal home use electromagnetic furnace, microwave oven, hair dryer and other electrical conditions, maternal menstrual blood volume, including total cholesterol, the history of antenatal distress, maternal culture, the average maternal home use electromagnetic furnace, microwave oven within a week. In terms of electrical appliances such as hair dryer, maternal menstrual blood volume before pregnancy is a risk factor (OR1, P0.05), diabetes history and Apgar score are protective factors (OR1, P0.05).
Conclusion:
1. the incidence of erythema in newborns is high, and there is no difference in the incidence of erythema among neonates.
2. the results of multiple factors analysis showed that the maternal culture, the electric electromagnetic furnace, microwave oven, electric hair dryer and so on within one week of pregnancy, the history of maternal diabetes, the amount of menstrual blood before pregnant women, the history of maternal prenatal distress, the total cholesterol level of the parturient, the Apgar score of the newborn were all the factors affecting the neonatal toxic erythema. The history of premenstrual distress, maternal culture, the use of electromagnetic furnace, microwave oven, hair dryer and other electrical appliances in a week of maternal home, the risk factors for pregnant women before pregnancy, the history of diabetes, and the Apgar score were protective factors.
3. before pregnant women, prenatal education, to ensure the balance of nutrition during pregnancy, and to avoid possible risk factors, to improve the physiological and psychological adaptability of women, and then to achieve eugenics and preferential treatment.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R722.1

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