本文選題：嬰幼兒 + 生長(zhǎng)發(fā)育��； 參考：《蘭州大學(xué)》2016年碩士論文

【摘要】：目的了解甘肅省貧困地區(qū)6-24月齡嬰幼兒喂養(yǎng)以及營(yíng)養(yǎng)不良現(xiàn)況,探討和分析與營(yíng)養(yǎng)不良有關(guān)的可能影響因素,為《甘肅省貧困地區(qū)兒童營(yíng)養(yǎng)改善試點(diǎn)項(xiàng)目》的評(píng)價(jià)提供基線數(shù)據(jù),也為政府制定嬰幼兒營(yíng)養(yǎng)不良預(yù)防策略和干預(yù)措施提供科學(xué)依據(jù)。方法采用多階段分層整群抽樣方法,結(jié)合PPS抽樣法(容量比例概率抽樣法),確定調(diào)查對(duì)象。調(diào)查對(duì)象為樣本村家庭6-24月齡嬰幼兒及其家長(zhǎng)或看護(hù)人,共調(diào)查了3663對(duì)6-24月齡嬰幼兒及其家長(zhǎng)或看護(hù)人。問(wèn)卷調(diào)查法和實(shí)驗(yàn)室檢測(cè)相結(jié)合,進(jìn)行現(xiàn)況流行病學(xué)調(diào)查,采用《甘肅省貧困地區(qū)兒童營(yíng)養(yǎng)改善試點(diǎn)項(xiàng)目》擬定的兒童基本情況問(wèn)卷、兒童出生及食物喂養(yǎng)情況問(wèn)卷、兒童家長(zhǎng)喂養(yǎng)與營(yíng)養(yǎng)知識(shí)調(diào)查問(wèn)卷,收集相關(guān)的流行病學(xué)研究資料;現(xiàn)場(chǎng)采集兒童指尖末梢血,用血紅蛋白便攜式分析儀快速檢測(cè)兒童血紅蛋白含量;通過(guò)嬰幼兒智能體檢儀現(xiàn)場(chǎng)測(cè)量?jī)和黹L(zhǎng)和體重值。數(shù)據(jù)采用Epidata3.1進(jìn)行雙錄入,Anthro3.2.2軟件計(jì)算身長(zhǎng)和體重的Z評(píng)分值,SPSS20.0軟件進(jìn)行統(tǒng)計(jì)分析。使用卡方檢驗(yàn)和Fisher確切概率法對(duì)營(yíng)養(yǎng)不良影響因素進(jìn)行單因素分析;使用非條件logistic回歸分析法對(duì)營(yíng)養(yǎng)不良影響因素進(jìn)行多因素分析。結(jié)果(1)調(diào)查對(duì)象的基本構(gòu)成情況:①共調(diào)查3663名6-24月齡兒童,其中男童1907名(52.1%),女童1756名(47.9%),男女性別比為1.1:1;低出生體重者占3.3%,巨大兒占3.6%;民族分布為:漢族2562名(69.9%),藏族847名(23.1%),回族150名(4.1%),東鄉(xiāng)族104名(2.8%);②父母平均年齡分別為28.5±4.7歲(19-50歲)和26.5±4.3歲(16-50歲),均以20-29歲者為主;父母親文化程度多在初中水平,分別占47.1%和42.7%;父親以無(wú)職業(yè)(38.6%)和從事農(nóng)業(yè)勞動(dòng)(32.5%)為主,母親以無(wú)職業(yè)(62.0%)為主,其次是從事農(nóng)業(yè)勞動(dòng)(19.1%)。(2)嬰幼兒看護(hù)情況:嬰幼兒看護(hù)人以母親為主(75.0%),其次是祖父母(21.5%);《家長(zhǎng)喂養(yǎng)與營(yíng)養(yǎng)知識(shí)調(diào)查》顯示看護(hù)人對(duì)嬰幼兒喂養(yǎng)與營(yíng)養(yǎng)知識(shí)平均得分為1.9±2.3分,及格率僅為16.5%。(3)嬰幼兒喂養(yǎng)情況:①嬰幼兒6個(gè)月內(nèi)喂養(yǎng)方式以混合喂養(yǎng)為主(60.6%),純母乳喂養(yǎng)率達(dá)到34.7%;②6個(gè)月后開(kāi)始添加輔食的占58.6%,4-5月齡開(kāi)始添加輔食的占21.1%;③本次調(diào)查中,已經(jīng)添加輔食的嬰幼兒占90.8%,尚未添加輔食的嬰幼兒占9.2%;攝入配方奶粉的占47.6%;嬰幼兒輔食種類(lèi)以谷類(lèi)(84.9%)、白心薯類(lèi)(53.5%)、蛋類(lèi)(43.7%)為主,肉類(lèi)、堅(jiān)果類(lèi)較少;攝入營(yíng)養(yǎng)素補(bǔ)充劑的嬰幼兒所占比例較低,僅有8.8%;營(yíng)養(yǎng)素中攝入鈣的比例較高,占16.2%,攝入鋅的比例最低,僅有5.0%。(4)嬰幼兒檢測(cè)指標(biāo):①嬰幼兒平均血紅蛋白值為11.5±1.6g/dl,59.0%嬰幼兒血紅蛋白值低于正常值;②嬰幼兒營(yíng)養(yǎng)不良發(fā)生率為21.3%,其中超重、消瘦、低體重和發(fā)育遲緩率分別為7.0%、4.0%、3.2%和7.1%。(5)嬰幼兒營(yíng)養(yǎng)狀況影響因素:①單因素卡方檢驗(yàn)結(jié)果顯示:月齡、性別、貧血狀況、是否早產(chǎn)、出生身長(zhǎng)和體重、看護(hù)人學(xué)歷和職業(yè)、6個(gè)月內(nèi)喂養(yǎng)方式、輔食添加時(shí)間、輔食添加種類(lèi)以及營(yíng)養(yǎng)素補(bǔ)充情況等與6-24月齡嬰幼兒營(yíng)養(yǎng)不良的發(fā)生之間存在相關(guān)性。②多因素非條件Logistic回歸分析結(jié)果顯示:影響6-24月齡嬰幼兒營(yíng)養(yǎng)狀況的因素有性別、月齡、是否早產(chǎn)、看護(hù)人科學(xué)喂養(yǎng)知識(shí)水平、看護(hù)人職業(yè)、輔食添加時(shí)間和輔食添加種類(lèi)。結(jié)論(1)甘肅省貧困地區(qū)6-24月齡嬰幼兒生長(zhǎng)發(fā)育遲緩檢出率高于《中國(guó)兒童發(fā)展綱要(2011—2020年)》的要求(7%以下),超重檢出率高于世界平均水平(6%),貧血患病率高達(dá)59.0%。超重、貧血是甘肅貧困地區(qū)6-24月齡嬰幼兒面臨的主要營(yíng)養(yǎng)問(wèn)題。(2)甘肅省貧困地區(qū)6-24月齡嬰幼兒6個(gè)月內(nèi)純母乳喂養(yǎng)率低于《中國(guó)兒童發(fā)展綱要(2011-2020)》要求水平(50%以上),使6個(gè)月內(nèi)嬰幼兒難以獲得最優(yōu)母乳營(yíng)養(yǎng),不利于兒童生長(zhǎng)發(fā)育。(3)甘肅省貧困地區(qū)6-24月齡嬰幼兒的輔食添加時(shí)間、輔食添加種類(lèi)、輔食添加質(zhì)量和頻率不合理,存在輔食添加時(shí)間早、輔食添加種類(lèi)單一、輔食質(zhì)量低、喂養(yǎng)頻率不合理等問(wèn)題,不利于嬰幼兒生長(zhǎng)發(fā)育。(4)甘肅省貧困地區(qū)嬰幼兒營(yíng)養(yǎng)狀況的影響因素包括嬰幼兒性別、月齡、是否早產(chǎn)、看護(hù)人科學(xué)喂養(yǎng)知識(shí)水平、看護(hù)人職業(yè)、輔食添加時(shí)間和輔食添加種類(lèi)。
[Abstract]:Objective to understand the status of feeding and malnutrition of 6-24 months old children in poor areas in Gansu Province, to explore and analyze the possible factors related to malnutrition, to provide baseline data for the evaluation of children's nutritional improvement pilot project in Gansu Province, and to provide the government to formulate prevention strategies and interventions for infant malnutrition. Methods using the multi-stage stratified cluster sampling method and the PPS sampling method (capacity ratio probability sampling) to determine the subjects. The survey subjects were 6-24 months old infants and their parents or caretakers in the sample village families. 3663 pairs of 6-24 month old infants and their parents or caretakers were investigated. Combined with the epidemiological survey, the basic situation questionnaire of children, the questionnaire of children's birth and food feeding, the questionnaire of the feeding and nutrition knowledge of children, the questionnaire of the feeding and nutrition knowledge of the children, and the data of epidemiological studies were collected, and the blood of the fingertips and blood of the children's fingertips were collected and the blood was collected from the children in the Gansu province. The content of children's hemoglobin was detected quickly by a portable erythropoin analyzer. The data of children's body length and weight were measured by the infant intelligent physical examination instrument. The data was recorded by Epidata3.1, and the value of Z for the body length and weight of the children was calculated by Anthro3.2.2 software, and the SPSS20.0 software was analyzed statistically. The chi square test and the exact probability method of Fisher were used. Single factor analysis of the factors affecting malnutrition; multifactor analysis on the factors affecting malnutrition by non conditional logistic regression analysis. Results (1) the basic composition of the respondents was: (1) a total of 3663 children of 6-24 months of age were investigated, including 1907 boys (52.1%), 1756 girls (47.9%), sex ratio of men and women, and low birth weight. The population accounted for 3.3% and the giant children accounted for 3.6%, the ethnic distribution was 2562 (69.9%), 847 Tibetans (23.1%), 150 Hui nationality (4.1%), and 104 (2.8%) of Dongxiang nationality, and the average age of parents was 28.5 + 4.7 (19-50 years) and 2562 years old. With no occupation (38.6%) and engaged in agricultural labor (32.5%), mother was dominated by no occupation (62%), followed by agricultural labor (19.1%). (2) infant care: infant caregivers were mothers (75%), followed by grandparents (21.5%); < family length feeding and Nutrition Knowledge > showed that the nursing and nutrition knowledge of the caregivers was flat. The average score was 1.9 + 2.3 points, and the passing rate was only 16.5%. (3) infant feeding situation: (1) the feeding mode of infant feeding in 6 months was mainly mixed feeding (60.6%), pure breastfeeding rate reached 34.7%; second, 6 months later added supplementary food 58.6%, 4-5 months of age began to add supplementary food to 21.1%; (3) in this survey, supplementary feeding infants accounted for 90. .8%, 9.2% of infants and young children who had not yet added supplementary food, 47.6% of formula milk powder, 84.9% of the cereals (84.9%), white heart and potato (53.5%), eggs (43.7%), meat and nuts were less; the proportion of infants and young children with nutrient supplements was low, only 8.8%; the proportion of calcium in nutrients was higher, 16.2%, and zinc intake. The ratio is the lowest, only 5.0%. (4) infant detection index: (1) the average hemoglobin value of infant is 11.5 + 1.6g/dl, 59% infant hemoglobin value is lower than normal, and the incidence of infant malnutrition is 21.3%, among which overweight, emaciation, low weight and growth retardation rate are divided into 7%, 4%, 3.2% and 7.1%. (5) infant nutrition status. 1. Single factor chi square test showed: month of age, sex, anemia, preterm birth, birth length and weight, nursing education and occupation, feeding mode, supplementary feeding time, supplementary food addition and nutrient supplement in 6 months were correlated with the occurrence of malnutrition in infants of 6-24 months of age. The results of conditional Logistic regression analysis showed that the factors affecting the nutritional status of 6-24 month old infants were gender, month old, preterm birth, nursing knowledge level, caregiver occupation, supplementary feeding time and supplementary food addition. (1) the rate of growth retardation in 6-24 months old infants in poor areas of Gansu was higher than that of < Chinese children. The requirement for child development program (2011 to 2020) > (below 7%), the prevalence of overweight was higher than the world average (6%), the prevalence of anemia was as high as 59.0%. overweight, anemia was the main nutritional problem for 6-24 months old infants in poor areas in Gansu. (2) the pure breastfeeding rate of 6-24 months old infants in poor areas in Gansu province was lower than that of Chinese children in 6 months. The exhibition program (2011-2020) > requires a level (more than 50%) to make it difficult for infants to get the best breast milk nutrition in 6 months, which is not conducive to the growth and development of children. (3) the supplementary feeding time of 6-24 months old children in the poor areas of Gansu Province, the kind of supplementary food, the quality and frequency of the supplementary food are not reasonable, the addition time of the supplementary food is early, and the addition of the supplementary food is single. The factors such as low quality of supplementary food and irrational feeding frequency are not conducive to the growth and development of infants. (4) the factors affecting infant nutrition in poor areas of Gansu include infant sex, month of age, preterm birth, knowledge level of nursing care, caregiver occupation, supplemental feeding time and supplementary food.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R723.2

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