本文選題：出生缺陷 + 影響因素　； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本研究通過調(diào)查太原市迎澤區(qū)2008~2015年圍產(chǎn)兒出生缺陷監(jiān)測資料,了解迎澤區(qū)出生缺陷的發(fā)生情況及變化趨勢,采用1:1匹配病例對照研究方法,分析出生缺陷發(fā)生的影響因素,探討針對性的護(hù)理干預(yù)對策,為出生缺陷的綜合防治提供參考依據(jù),以減少出生缺陷的發(fā)生,提高出生人口素質(zhì)。方法:1.太原市迎澤區(qū)2008~2015年圍產(chǎn)兒出生缺陷監(jiān)測結(jié)果分析收集2008~2015年太原市迎澤區(qū)出生缺陷監(jiān)測醫(yī)院的監(jiān)測資料,獲得迎澤區(qū)八年間圍產(chǎn)兒出生缺陷數(shù)據(jù),包括圍產(chǎn)兒出生總數(shù)、出生缺陷總數(shù)、出生缺陷種類和出生缺陷兒轉(zhuǎn)歸情況等,錄入Excel表,建立數(shù)據(jù)庫,運(yùn)用發(fā)生率、構(gòu)成比等簡單統(tǒng)計(jì)學(xué)方法,分析迎澤區(qū)圍產(chǎn)兒出生缺陷的發(fā)生情況及變化趨勢。2.太原市迎澤區(qū)圍產(chǎn)兒出生缺陷影響因素研究及護(hù)理干預(yù)采用1:1匹配病例對照研究方法,病例組和對照組相關(guān)資料從太原市婦幼保健綜合管理平臺獲取,錄入Excel表,建立數(shù)據(jù)庫,采用SPSS19.0軟件包進(jìn)行單因素條件Logistic回歸分析及多因素條件logistic回歸分析,探討影響出生缺陷發(fā)生的相關(guān)因素及護(hù)理干預(yù)效果。結(jié)果:1.太原市迎澤區(qū)2008~2015年圍產(chǎn)兒出生缺陷監(jiān)測結(jié)果分析(1)太原市迎澤區(qū)2008~2015年共監(jiān)測圍產(chǎn)兒56723例,其中出生缺陷兒853例,出生缺陷總發(fā)生率為150.38/萬,全國圍產(chǎn)兒出生缺陷總發(fā)生率為145.06/萬,迎澤區(qū)圍產(chǎn)兒出生缺陷發(fā)生率總體高于全國監(jiān)測數(shù)據(jù)。從整體來看,2010~2012年為迎澤區(qū)出生缺陷發(fā)生的高峰期,2012~2014年出現(xiàn)波動,此后維持在較高水平。(2)迎澤區(qū)2008~2015年出生缺陷以先天性腦積水、多指(趾)、神經(jīng)管畸形、外耳畸形及先天性心臟病為主。先天性心臟病的順位不斷上升,2015年躍居首位,與全國監(jiān)測趨勢保持一致;神經(jīng)管缺陷的順位已退出前五,但其防治形勢依然嚴(yán)峻。2.太原市迎澤區(qū)圍產(chǎn)兒出生缺陷影響因素研究及護(hù)理干預(yù)(1)多因素條件logistic回歸分析顯示:葉酸增補(bǔ)(OR=0.548)、產(chǎn)前檢查(OR=0.320)為出生缺陷的保護(hù)因素,以往不良妊娠結(jié)局(OR=1.769)、父親吸煙(OR=1.379)、妊娠合并癥:妊娠期高血壓疾病(OR=1.675)、妊娠期糖尿病(OR=2.013)、其他妊娠合并癥(OR=1.590)為出生缺陷的危險(xiǎn)因素。(2)影響出生缺陷發(fā)生的因素是多方面的,多因素條件logistic回歸分析顯示:圍孕期積極增補(bǔ)葉酸,增加產(chǎn)前檢查次數(shù),養(yǎng)成良好生活習(xí)慣并注意妊娠期間患病情況是影響出生缺陷的重要因素,通過開設(shè)孕婦學(xué)校、設(shè)立產(chǎn)前咨詢門診、實(shí)施孕早期門診咨詢-產(chǎn)前檢查-分娩全程健康教育的護(hù)理干預(yù)措施,增強(qiáng)孕產(chǎn)婦的自我保健意識、改善其不良生活方式,引導(dǎo)孕產(chǎn)婦形成正確的產(chǎn)前檢查行為,減少不良結(jié)局的發(fā)生。結(jié)論:1.太原市迎澤區(qū)圍產(chǎn)兒出生缺陷發(fā)生率總體處于較高水平,高于全國監(jiān)測數(shù)據(jù)。出生缺陷以先天性腦積水、多指(趾)、神經(jīng)管畸形、外耳畸形及先天性心臟病為主。2.葉酸增補(bǔ)和產(chǎn)前檢查為出生缺陷的保護(hù)因素;以往不良妊娠結(jié)局、父親吸煙及妊娠合并癥為出生缺陷的危險(xiǎn)因素。3.開設(shè)孕婦學(xué)校、設(shè)立產(chǎn)前咨詢門診、實(shí)施門診-產(chǎn)檢-分娩全程健康教育的護(hù)理干預(yù)措施,可以有效降低不良結(jié)局發(fā)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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.72

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