本文選題：新生兒毒性紅斑 + 發(fā)病率　； 參考：《吉林大學》2013年碩士論文

【摘要】：新生兒毒性紅斑又稱新生兒中毒性紅斑、新生兒過敏性紅斑，簡稱新生兒紅斑，是新生兒期常見病，發(fā)病率約30%~70%。國內(nèi)關(guān)于新生兒紅斑的報道較少，大多停留在對產(chǎn)婦生產(chǎn)前后的環(huán)境因素和新生兒初始狀態(tài)的個別因素上，指導臨床工作的實踐意義不足。本次研究擬調(diào)查在我院生產(chǎn)的產(chǎn)婦及所產(chǎn)新生兒，通過問卷調(diào)查及血生化指標檢查，描述新生兒紅斑患病現(xiàn)狀，探討其可能的影響因素，并提出相應(yīng)的護理建議，為不同類型產(chǎn)婦及所產(chǎn)新生兒提供預(yù)防新生兒紅斑的參考。 目的：了解長春市婦產(chǎn)醫(yī)院產(chǎn)科新生兒紅斑發(fā)病率、分布特征和影響因素，進而提出新生兒紅斑的預(yù)防和護理的對策及建議。 方法：本研究以2012年8月至2013年7月在吉林省長春市某婦產(chǎn)醫(yī)院某療區(qū)出生的新生兒為研究對象，根據(jù)2010年《實用新生兒學》新生兒毒性紅斑的診斷標準診斷新生兒紅斑。采用自行編制信息表調(diào)查產(chǎn)婦的人口學信息、產(chǎn)婦孕期生活習慣、既往病史、分娩方式、血生化指標等，同時調(diào)查嬰兒基本信息、新生兒紅斑情況等相關(guān)信息。數(shù)據(jù)采用EpiData建立數(shù)據(jù)庫并進行數(shù)據(jù)平行雙錄入，用SPSS19.0統(tǒng)計軟件進行描述性統(tǒng)計、卡方檢驗組間比較和影響因素的logistic分析統(tǒng)計分析。 結(jié)果： 1.調(diào)查結(jié)果顯示該醫(yī)院新生兒毒性紅斑發(fā)病率為56.70%(368/649)，男性新生兒的發(fā)病率為55.29%，女性新生兒的發(fā)病率為58.18%，不同性別新生兒紅斑發(fā)病率差異無統(tǒng)計學意義(χ2=0.55，p=0.458)。 2.368例患病新生兒中出生當天發(fā)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%；單純發(fā)生在面部占患病新生兒總數(shù)25.54%；單純發(fā)生在軀干部占34.24%；單純發(fā)生在四肢占27.72%；發(fā)生在面部和軀干部占1.90%；發(fā)生在軀干部和四肢占0.54%；發(fā)生在其他部位占10.05%。 3.影響因素單因素分析結(jié)果顯示新生兒中毒性紅斑與產(chǎn)婦年齡、產(chǎn)婦文化程度、新生兒體重、新生兒Apgar評分、孕期食用豬牛羊肉及禽類頻率、平均一周內(nèi)產(chǎn)婦家中使用電磁爐、微波爐、電吹風等電器情況、孕次、有無人工流產(chǎn)史、有無糖尿病、孕前月經(jīng)周期、分娩方式、產(chǎn)前窘迫史、甘油三酯、總膽固醇和低密度脂蛋白等17個因素有關(guān)(P0.05)，與民族、家庭人均收入、新生兒性別、新生兒窒息史、吸煙、飲酒、飲食是否規(guī)律、其他既往病史及分娩因素等30個因素無關(guān)(P0.05)。 4.以新生兒是否患新生兒紅斑作為因變量，將單因素分析中P0.10的因素作為自變量，引入多因素Logistic回歸模型，采用多因素非條件逐步回歸分析的方法進行多因素分析，分析結(jié)果顯示模型擬合良好(χ2=93.538，P0.001)，共有7個因素最終進入方程，分別是總膽固醇、糖尿病史、產(chǎn)前窘迫史、Apgar評分、產(chǎn)婦文化程度、平均一周內(nèi)產(chǎn)婦家中使用電磁爐、微波爐、電吹風等電器情況，產(chǎn)婦孕前月經(jīng)血量。其中總膽固醇、產(chǎn)前窘迫史、產(chǎn)婦文化程度、平均一周內(nèi)產(chǎn)婦家中使用電磁爐、微波爐、電吹風等電器情況，產(chǎn)婦孕前月經(jīng)血量是危險因素(OR1，P0.05)，糖尿病史、Apgar評分是保護因素(OR1，P0.05)。 結(jié)論： 1.新生兒紅斑發(fā)病率較高，男女新生兒新生兒紅斑發(fā)病率無差異。 2.多因素分析結(jié)果顯示產(chǎn)婦文化程度，產(chǎn)婦孕期一周內(nèi)家中使用電磁爐、微波爐、電吹風等電器情況，產(chǎn)婦糖尿病史，產(chǎn)婦孕前月經(jīng)血量，產(chǎn)婦產(chǎn)前窘迫史，產(chǎn)婦總膽固醇水平，新生兒Apgar評分都為新生兒中毒性紅斑的影響因素�？偰懝檀�、產(chǎn)前窘迫史、產(chǎn)婦文化程度、平均一周內(nèi)產(chǎn)婦家中使用電磁爐、微波爐、電吹風等電器情況，產(chǎn)婦孕前月經(jīng)血量是危險因素，糖尿病史、Apgar評分是保護因素。 3.應(yīng)對產(chǎn)婦進行孕前、產(chǎn)前教育，保證其孕期營養(yǎng)均衡，并盡量避免可能的危險因素，提高產(chǎn)婦的生理、心理適應(yīng)能力，，進而做到優(yōu)生優(yōu)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.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R722.1

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