本文選題：兒童　切入點：哮喘　出處：《安徽醫(yī)科大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的支氣管哮喘（簡稱哮喘）是小兒時期最常見的呼吸道過敏性疾病，，嚴重影響兒童身心健康，近年來，世界各國兒童哮喘患病率都呈上升趨勢。我國兒童哮喘發(fā)病率亦有上升趨勢，安慶市城區(qū)兒童哮喘發(fā)病情況及其與其他城市是否有差別，以往少見報道。按照全國兒童哮喘流調(diào)協(xié)作組及國家疾病預防控制中心（Centers for Disease Control，CDC）的要求，我們于2010年10月1日至2011年9月30日對安慶市城區(qū)10000名0～14歲兒童進行了哮喘流行病學調(diào)查，旨在了解本地區(qū)小兒哮喘發(fā)病情況及相關(guān)因素，為更好地防治兒童哮喘提供科學依據(jù)。 方法采用整群隨機抽樣和電話家訪相結(jié)合的方式，對安慶市迎江、大觀（含石化轄區(qū)）10000例0～14歲兒童進行哮喘流行病學調(diào)查。調(diào)查對象為所在調(diào)查地區(qū)的幼兒園、中小學和散居兒童。自1996年7月1日零點～2010年6月30日11時59分之間出生的兒童。采用全國哮喘防治協(xié)作組制定的統(tǒng)一方案、步驟和問卷，由本科室經(jīng)過正規(guī)培訓的兒科醫(yī)師協(xié)助組成調(diào)查小組，首先使用兒童哮喘初篩調(diào)查表對上述對象進行調(diào)查，篩選出可疑哮喘，再對可疑患兒進行詳細詢問病史和必要的體格檢查，為避免家長記憶錯誤，凡有病歷的均核對門診病歷和住院病歷，符合診斷標準的兒童填寫正式調(diào)查表。 結(jié)果（1）從9173（發(fā)出10000張表收回9173張，容許流失率10%）名兒童中篩查出哮喘患兒338例，安慶市0～14歲兒童哮喘累計患病率是3.68%，其中兒童哮喘297例（87.87%）、嬰幼兒哮喘41例（12.13%）。男女之比是1.77:1，男性累計患病率(4.49%)高于女性(2.80%)，差異有顯著性(χ2=18.33，P0.05)。現(xiàn)患患病率為2.74%。發(fā)病率最高的年齡階段是1～8歲。首次發(fā)病年齡3歲以前者占89.94%。（2）哮喘發(fā)作的誘因以上呼吸道感染為主，占73.96%，其次是天氣變化或接觸冷空氣，占70.12%。哮喘發(fā)病季節(jié)以換季和冬季為主，好發(fā)時辰相當一部分無規(guī)律性，其次以午夜和清晨為主。使用過抗生素治療者占71.30%，而接受吸入激素者占45.23%。（3）哮喘兒童中一、二級親屬有哮喘史分別占10.65%和10.95%，個人過敏史占32.54%，濕疹占30.18%，過敏性鼻炎占47.93%，蕁麻疹占21.89%。 結(jié)論本次調(diào)查發(fā)現(xiàn)男性患病率高于女性，89.94%的患兒3歲以前發(fā)病，1～8歲是哮喘發(fā)病的高峰年齡段。發(fā)病誘因以呼吸道感染最常見，其次是天氣變化或接觸冷空氣，此外運動、被動吸煙等與哮喘發(fā)病有關(guān)。在哮喘治療過程中大多數(shù)患兒使用過抗生素，而接受吸入激素治療者比例較低。
[Abstract]:Objective bronchial asthma (Asthma) is the most common respiratory allergic disease in childhood, which seriously affects the physical and mental health of children. The prevalence of asthma in children all over the world is on the rise. The incidence of asthma in children in China is also on the rise. The incidence of asthma in urban areas of Anqing City is different from that in other cities. Rarely reported in the past. According to the request of the National Children's Asthma flow Coordination Group and the National Centers for Disease Control and Prevention, From October 1st 2010 to September 30th 2011, we conducted an epidemiological survey on asthma among 10000 children aged 14 years old in Anqing City, in order to understand the incidence of asthma and its related factors. To provide scientific basis for better prevention and treatment of childhood asthma. Methods A cluster random sampling combined with telephone home visits was used to investigate the epidemiology of asthma among 10 000 children aged 0 to 14 years old in Yingjiang and Daguan areas of Anqing city. Children born between 00:00 and 11:59 on July 1st 1996 and June 30th 2010, children born in primary and secondary schools and in the diaspora, using a unified programme, steps and questionnaires developed by the National Asthma Prevention and Control Cooperation Group, With the help of a regular trained pediatrician in our department, a survey team was formed. First, the above subjects were investigated by using the child asthma screening questionnaire, and suspected asthma was screened out. In order to avoid the parents' memory errors, all the medical records of outpatients and inpatients were checked, and the children who met the diagnostic criteria filled out a formal questionnaire. Results 1) 338 children with asthma were screened out of 9173 children (9173 sheets were issued and the allowable wastage rate was 10). The cumulative prevalence of asthma was 3.68 in 14 year old children in Anqing city, including 297 cases of asthma in children (87.87%) and 41 cases of asthma in infants (12.13131.The ratio of male to female was 1.77: 1, the cumulative prevalence rate of male was 4.49%), and the difference was significant (蠂 218.33 P 0.055.The prevalence rate was 2.74%). The first onset age was 3 years (89.94%). The main cause of asthma attack was upper respiratory tract infection. Accounting for 73.96, followed by weather changes or exposure to cold air, accounting for 70.12.The incidence of asthma is mainly seasonal and winter, and a considerable part of the predilection time is irregular. The second was midnight and early morning. Those who had been treated with antibiotics accounted for 71.30, while those who received inhaled hormones accounted for 45.23.03) of the children with asthma, 10.65% and 10.95 had a history of asthma in the second degree relatives, 32.54 had a history of personal allergies, 30.18 in eczema, 47.93 in allergic rhinitis and 21.8900m in urticaria. Conclusion the prevalence rate of male children is 89.94% higher than that of females. The peak age of asthma onset is before 3 years of age. Respiratory tract infection is the most common cause, followed by weather changes or exposure to cold air, in addition to exercise. Passive smoking was associated with asthma. Most of the children had used antibiotics in the course of asthma treatment, but the proportion of those who received inhaled hormone therapy was lower.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R725.6

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