【摘要】：目的:調查重慶市計劃妊娠人群的健康現(xiàn)狀,分析該類人群的健康狀況在不同的年齡段、文化程度、職業(yè)、民族等等之間的分布,依照孕前優(yōu)生健康檢查風險評估標準對計劃妊娠人群進行評估分類,探討風險人群的影響因素,為改善重慶市計劃妊娠人群的健康狀況提供科學依據(jù),促進優(yōu)生優(yōu)育。方法:本研究按地區(qū)分層依照每個地區(qū)計劃妊娠人口的比例進行多階段整群隨機抽樣。在全市40個區(qū)縣抽取符合生育政策的共10786人即5393對計劃妊娠夫婦進行問卷調查和相關的體格檢查。調查計劃妊娠人群的人口社會學特征、既往疾病史、孕育史、家族史、不良生活習慣、環(huán)境有毒有害物質接觸史、社會心理壓力因素并進行健康體檢�；厥沼行柧�9384份,回收率為87%。采用Epi Data3.2統(tǒng)計軟件建立數(shù)據(jù)庫,用雙錄的方式錄入數(shù)據(jù),按照孕前優(yōu)生風險評估標準對計劃妊娠人群進行分類,并依此劃分為一般人群和風險人群。用SPSS17.0統(tǒng)計軟件對樣本資料進行統(tǒng)計學分析,用現(xiàn)況調查的方法進行研究,計數(shù)資料用率、構成比進行描述,對相關因素與風險人群的關系進行卡方檢驗。對可能影響計劃妊娠人群的健康風險因素采用多因素非條件Logistic回歸分析。結果1.重慶市9384名即4692對計劃妊娠夫婦中,男性參檢人群中風險人群占5.86%,一般人群占比94.14%;女性參檢人群中風險人群占28.64%,一般人群占比71.36%;風險人群比例較低;2.經(jīng)單因素分析,檢出男性風險人群的危險因素有年齡(χ2=14.5723,P=0.0001)、地區(qū)(χ2=31.5502,P0.0001)、乙肝疾病史(χ2=60.9689,P0.0001)、乙肝疫苗接種史(χ2=12.6811,P=0.0004)、體重指數(shù)異常(χ2=6.5551,P=0.0377)、血壓異常(χ2=6.1461,P=0.0132)、HBs Ab(χ2=842.0512,P0.0001);經(jīng)多因素logistic回歸分析,有統(tǒng)計學意義的結果中:乙肝疾病史(OR=6.587)、BMI≥24.00(OR=1.577)、高血壓(OR=1.836)是男性風險人群的危險因素;而20≤年齡35(OR=0.613)、渝東南生態(tài)保護區(qū)相對于都市功能核心區(qū)(OR=0.434)、乙肝疫苗接種史(OR=0.608),HBs Ab陽性(OR=0.383)是男性風險人群的保護因素。3.經(jīng)單因素分析,檢出女性風險人群相關的危險因素有地區(qū)(χ2=45.4756,P0.0001)、民族(χ2=5.8426,P=0.0156)、文化程度(χ2=94.9953,P0.0001)、職業(yè)(χ2=25.4574,P=0.0004)、乙肝疾病史(χ2=6.0067,P=0.0143)、風疹疫苗接種史(χ2=8.2669,P=0.0040)、生活/工作壓力(χ2=11.6018,P=0.0007)、經(jīng)濟壓力(χ2=12.9845,P=0.0003)。經(jīng)多因素logistic回歸分析,有統(tǒng)計學意義的結果中:地區(qū)中城市發(fā)展新區(qū)(OR=1.641)、渝東北生態(tài)涵養(yǎng)發(fā)展區(qū)(OR=1.65)、渝東南生態(tài)保護區(qū)(OR=2.028)相對于都市功能核心區(qū)、乙肝疾病史是女性風險人群的危險因素;而文化程度中高中(OR=0.114)和大學(OR=0.371)相對于小學及以下、工人相對于農(nóng)民(OR=0.656)、風疹疫苗接種(OR=0.686)是女性風險人群的保護因素。結論本研究通過分析重慶市9384名(4692對夫婦)計劃妊娠人群健康現(xiàn)狀和風險研究,分別從社會人口學特征、體格檢查、實驗室檢查情況分析,并依照風險因素進行分類,對相關風險因素進行統(tǒng)計學分析。得出如下結論:1.本文通過健康檢查、風險評估,結果顯示,重慶市計劃妊娠人群總體健康狀況較好,風險人群所占比例較低;2.重慶市計劃妊娠人群中,風險人群中女性比男性比例高,應加強對女性計劃妊娠人群的孕前保健工作,引導女性增強優(yōu)生優(yōu)育意識,增加醫(yī)療保健服務的利用率;3.乙型肝炎疾病史、肥胖、高血壓是男性風險人群的主要危險因素。適齡生育、適宜環(huán)境和乙肝表面抗體陽性是男性風險人群的保護因素。應對男性加強宣傳教育,加強男性計劃妊娠人群的健康管理,避免危險因素;4.女性風險人群的危險因素是乙型肝炎疾病史、地區(qū)經(jīng)濟水平落后、職業(yè)暴露。保護因素是文化程度高、職業(yè)暴露少和接種風疹疫苗。應積極提高女性的受教育程度,增強女性的自我保健意識,提高自我保護能力。
[Abstract]:Objective: To investigate the health status of the pregnant population in Chongqing, and to analyze the distribution of the health status of the population in different age groups, the degree of culture, the occupation, the nationality and so on. To explore the influencing factors of the risk population, to provide the scientific basis for improving the health status of the pregnant women in Chongqing, and to promote the good and healthy development. Methods: A multi-stage cluster random sampling was conducted according to the proportion of the pregnant population in each district according to the regional stratification. A total of 107,86 persons,5393, who were in line with the reproductive policy in 40 districts of the city, were investigated and the relevant physical examination was conducted. The demographic and social characteristics of the pregnant population of the planned pregnancy, the history of previous diseases, the history of inoculation, the family history, the bad living habits, the contact history of the toxic and harmful substances in the environment, the factors of social stress and the physical examination of the health were investigated. The effective rate of recovery was 9384 and the recovery rate was 87%. The database was established by using Epi Data3.2 statistical software, and the data were recorded in a two-record manner. The planned pregnancy population was classified according to the pre-pregnancy risk assessment standard and classified into the general population and the risk group. The statistical analysis of the sample data was carried out by using the SPSS17.0 statistical software, and the method of current status investigation was used to study the data rate and the composition ratio, and the relationship between the related factors and the risk population was chi-square test. A multi-factor, non-conditional logistic regression analysis was used for the health risk factors that might affect the planned pregnancy population. Results 1. Of the 9384 pregnant couples in Chongqing, the risk group was 5.86%, the general population was 94.14%, the risk group was 28.64%, the general population was 71.36%, and the proportion of the risk group was lower. The risk factors of the male risk group were analyzed by single factor analysis. The risk factors of the male risk group were age (2 = 14.5723, P = 0.0001), the history of hepatitis B (2 = 60.9689, P.0001), the history of hepatitis B vaccine (2 = 12.6811, P = 0.0004), the body weight index was abnormal (Sup2 = 6.5551, P = 0.0377), and the blood pressure was abnormal (Sup2 = 6.1461, P = 0.0132). The history of hepatitis B disease (OR = 6.587), BMI of 24.00 (OR = 1.577) and high blood pressure (OR = 1.836) were the risk factors of the male risk group, and 20% of age 35 (OR = 0.613). Compared with the core area of urban function (OR = 0.434), the history of hepatitis B vaccination (OR = 0.608), the positive of HBs Ab (OR = 0.383) was the protection factor of the male risk group. The risk factors associated with the women's risk groups were analyzed by single factor analysis (2 = 45.4756, P = 0.0156), nationality (Sup2 = 5.8426, P = 0.0156), degree of culture (Sup2 = 94.9953, P.0001), occupation (Sup2 = 25.4574, P = 0.0004), history of hepatitis B (2 = 6.0067, P = 0.0143), and history of vaccination with rubella (Sup2 = 8.2669, P = 0.0040). Life/ working pressure (Sup2 = 11.6018, P = 0.0007), Economic pressure (Sup2 = 12.9845, P = 0.0003). Based on the multi-factor logistic regression analysis, there are statistical significance: in the region, the urban development new area (OR = 1.641), the northeast-Chongqing ecological conservation and development area (OR = 1.65), and the southeast-southeast ecological protection area (OR = 2.028) are relative to the core area of the urban function, and the history of the hepatitis B disease is the risk factor of the female risk group; The high school (OR = 0.114) and the university (OR = 0.371) in the degree of culture were compared with the primary and the following, and the worker was relative to the farmer (OR = 0.656), and the rubella vaccination (OR = 0.686) was the protection factor for the female risk population. Conclusion The present study analyzed the health status and risk of 9384 (4692 couples) in Chongqing, and analyzed the relevant risk factors from the social and demographic characteristics, physical examination and laboratory examination, and classified them according to the risk factors. The following conclusions are drawn:1. The results of health examination and risk assessment show that the overall health status of the pregnant population in Chongqing is good, and the proportion of the risk population is lower; In the pregnant population of Chongqing, the proportion of women in the risk group is higher than that of the male, and the pre-pregnancy health-care work of the pregnant population of the female plan should be strengthened to guide the female to enhance the awareness of the quality and care and increase the utilization rate of the health care service; Hepatitis B disease history, obesity, hypertension are the main risk factors of the male risk population. Age-appropriate fertility, proper environment and positive anti-hepatitis B antibody are the protective factors of the male risk population. To strengthen the publicity and education of men, strengthen the health management of the male plan pregnant population, and avoid the risk factors;4. The risk factors of the female risk group are the history of the hepatitis B disease, the backward of the regional economy and the occupational exposure. The protection factor is the high degree of culture, the low occupational exposure and the vaccination of rubella. The education of women should be improved, the self-care consciousness of women should be enhanced, and the self-protection ability should be improved.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R169.1

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