重庆市孤儿口腔健康状况调查及口腔综合干预效果评估

发布时间：2018-05-02 04:35

本文选题：孤儿 + 口腔健康　；参考：《重庆医科大学》2014年硕士论文

【摘要】：背景孤儿是指失去因父母死亡或是父母没有能力抚养其长大而失去父母照顾的0-18岁未成年人。在亚洲，共有孤儿5700多万人，占总儿童人口数的5.8%。至2011年，中国孤儿数量有50.9万。重庆地区内孤儿总数为10080人，其中在福利机构集中供养1699人，占孤儿总数的16.8%。口腔健康是全身健康的一个重要组成部分。近十多年来，在口腔、卫生等专业人员的共同努力下，在口腔疾病防治方面做了大量工作，我国的口腔卫生保健事业取得了长足的进步。但对于孤儿，因其居住环境拥挤、缺乏足够的工作人员、孤儿周围缺乏足够的口腔保健宣传、孤儿自身口腔习惯不良、口腔卫生不佳、对口腔健康的重视程度低，龋病、牙龈炎发病率高，又因经济条件等客观因素的限制，孤儿口腔科就医率低，口腔疾病成为影响孤儿健康的一个重要问题。口腔综合干预，能有效改善孤儿口腔卫生状况，提高孤儿口腔健康水平。目前，国内外关于孤儿这一弱势群体的口腔健康状况的研究相对较少，在国内尤其欠缺，因此，初步掌握我国孤儿口腔健康状况，为制定适宜的孤儿口腔保健计划提供一定的依据显得尤为重要。目的本研究采用简单随机抽样的方法，通过口腔健康检查及问卷调查，初步掌握重庆市孤儿口腔健康现状、口腔健康行为及流行趋势，同时实施口腔疾病综合干预，并进行效果评估，为制定适宜的孤儿口腔保健计划提供一定的依据。方法采用简单随机抽样的方法抽取重庆市儿童爱心庄园孤儿为调查对象，依照WHO口腔健康调查基本方法（第4版，1997）与全国第三次口腔流行病学调查方法（2005）对该福利院现居住317名孤儿进行口腔健康检查，记录龋齿、牙龈出血和牙结石情况；对能独立完成（或在口腔医师的协助下能独立完成）调查问卷的孤儿进行口腔健康知识及口腔保健行为调查。同时采取口腔综合干预措施包括口腔健康宣教、局部用氟、窝沟封闭、早期恒牙龋齿充填等，并对其效果进行评估。采用SPSS17.0软件对数据进行统计分析。结果1.重庆市孤儿乳牙龋失补率及龋均分别为50.00%，1.94，男女之间差异无统计学意义（P0.05）。恒牙龋失补率及龋失补均分别为39.53%，0.90，男女之间差异无统计学意义（P0.05）。恒牙龋失补率12岁及以下年龄组与12岁以上年龄组间差异有统计学意义（P0.05），龋失补均两组之间差异无统计学意义。龋齿充填率为零。牙龈出血检出率78.22%，不同性别及不同年龄组间差异均无统计学意义（P0.05）。牙结石检出率67.66%，不同性别间差异无统计学意义（P0.05），12岁及以下年龄组小于12岁以上年龄组，差异均有统计学意义（P＜0.05）。 2.孤儿对口腔健康知识知晓率52.80%，正确口腔卫生行为报告率为32.36%，进食饼干、蛋糕、糖果、碳酸饮料、果汁等含糖食品频率≤每周1次的报告率均接近或大于70%。孤儿牙科就诊行为报告率较低，仅有14.53%儿童曾看过牙医。 3.实施口腔综合干预措施后孤儿口腔健康水平有明显提高。乳牙龋病发病率为1.85%，恒牙为1.38%。恒牙龋齿充填率为48.89%。恒牙龋齿均值（DT）明显降低（P＜0.05），龋补均值（FT）明显升高（P＜0.05）。健康教育后孤儿口腔健康知识知晓率提高了36.59%，正确口腔卫生行为报告率增加了55.57%。结论重庆市孤儿口腔健康不佳，牙科服务利用率极低，口腔治疗需求较大，口腔健康知识知晓情况一般，卫生保健习惯不佳；口腔综合干预能有效提高孤儿口腔健康知识知晓情况，促进孤儿形成良好的口腔卫生习惯，提高孤儿口腔健康水平。在今后的工作中，对于孤儿的口腔健康我们应给予更多的关注，，应将孤儿纳入口腔健康预防保健的重点人群之列。
[Abstract]:Background orphans are 0-18 year old minors who have lost their parents' death because of their parents' death or their parents' inability to raise their parents. In Asia, there are about 57000000 orphans, accounting for 509 thousand of the total number of orphans in China from 5.8%. to 2011. The total number of orphans in the Chongqing region is 10080, of which the welfare institutions are concentrated. 1699 people, accounting for 16.8%. of the total orphans
Oral health is an important part of the health of the whole body. In the past more than 10 years, a lot of work has been done in the prevention and control of oral diseases in the joint efforts of the oral and health professionals. The cause of oral health care in our country has made great progress. But for the orphans, the lack of enough staff and the lack of staff because of their crowded living environment. The lack of adequate oral health publicity around children, poor oral habits of orphans themselves, poor oral hygiene, low attention to oral health, high incidence of dental caries, gingivitis, and economic conditions and other objective factors, the low rate of medical treatment in orphan Department of Stomatology, oral disease has become an important issue affecting the health of orphans.
Comprehensive oral intervention can effectively improve the oral health status of orphans and improve the oral health level of orphans.
At present, there are relatively few studies on the oral health status of the orphans at home and abroad, especially in the country. Therefore, it is very important to grasp the oral health status of the orphans in our country and provide a certain basis for the formulation of the appropriate orphan oral health care plan.
Objective to investigate the oral health status, oral health behavior and epidemic trend of orphans in Chongqing by oral health examination and questionnaire survey by simple random sampling, and to carry out comprehensive intervention of oral diseases and evaluate the effect of oral health, and to provide a certain basis for the formulation of appropriate orphan oral health care plan.
Methods a simple random sampling method was used to investigate the orphans in Chongqing children's love manor gardens. According to the basic methods of WHO oral health survey (Fourth Edition, 1997) and the third national oral epidemiological survey methods (2005), 317 orphans living in the welfare hospital were examined for oral health, and the dental caries, gingival bleeding and dental calculus were recorded. Investigation of oral health knowledge and oral health care behavior for orphans who were able to complete the questionnaire independently (or with the assistance of the dentist independent). The oral health intervention measures including oral health education, local fluorine, pit and fissure sealing, and early constant dental caries filling were taken, and the effect was evaluated by SPS. The S17.0 software carries out statistical analysis of the data.
Results 1. in Chongqing, the rate of dental caries and caries were 50% and 1.94, respectively, and there was no significant difference between men and women (P0.05). The loss rate of dental caries and dental caries were 39.53% and 0.90, respectively, and there was no significant difference between men and women (P0.05). The difference between the age group of the permanent tooth decay and the age group of 12 years and below and the age group over 12 years old was statistically significant. Significance (P0.05), the difference between the two groups was not statistically significant. The rate of dental caries filling was zero. The detection rate of gingival bleeding was 78.22%, there was no significant difference between different sex and age groups (P0.05). The detection rate of dental calculus was 67.66%, there was no statistical difference between different sexes (P0.05), and the age group of 12 years old and below was less than 12 years of age. The difference was statistically significant (P < 0.05).
The rate of oral health knowledge was 52.80% in 2. orphans. The rate of correct oral health behavior was 32.36%. The rate of eating biscuits, cake, candy, carbonated beverage, juice and so on was less than 1 times a week or more than 70%. orphans, and only 14.53% children had seen dentists.
3. the oral health level of the orphans was obviously improved after the oral comprehensive intervention. The incidence of decayed tooth caries was 1.85%, the average dental caries filling rate of the permanent teeth (DT) was significantly lower (P < 0.05) and the mean value of dental caries (FT) was significantly higher (P < 0.05). The awareness rate of oral health knowledge of orphans was increased by 36.59% after health education. The rate of correct oral hygiene behavior increased by 55.57%.
Conclusion the oral health of orphans in Chongqing is poor, the utilization rate of dental service is very low, the need of oral treatment is great, the knowledge of oral health is general, and the habit of health care is not good. The comprehensive oral intervention can effectively improve the knowledge of oral health knowledge of orphans, promote the orphans to form good oral hygiene habits, and improve the oral health of orphans. In the future work, we should pay more attention to the oral health of the orphans. The orphans should be included in the key population of oral health prevention and health care.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R780.1

【参考文献】