194例婴幼儿发锌调查结果分析

[目的] 探讨深圳市龙华镇婴幼儿发锌情况.[方法]将材料按年龄分成5组用光谱法测定发锌含量（参考值124.0～415.0 μg/g）.[结果]缺锌情况随年龄增加而明显降低,人工喂养儿及混合喂养儿缺锌率高于母乳喂养儿.健康婴幼儿发锌性别之间无显著性差异.[结论]缺锌与多种因素有关,但最主要的原因还是膳食锌摄入不足.为减少发病率,提倡母乳喂养,及时添加辅助饮食,注意补充含锌丰富的食物,养成良好的饮食习惯.     

赞皇县2004～2008年婴幼儿营养状况调查分析

目的:了解赞皇县农村5 岁以下儿童中、重度营养不良程度及发病原因,为改善儿童营养提供科学依据.方法:根据赞皇县妇幼保健科统计报表,统计2004～2008年5岁以下儿童调查人数、营养不良人数及6个月以下纯母乳喂养人数.2008年随机抽取全县5岁以下儿童共5 425人进行健康体检,向家长发放调查表,了解营养不良的相关因素,并对调查数据进行统计分析.结果:2004～2008年我县5岁以下儿童营养不良发生率呈逐渐下降趋势,影响婴幼儿营养不良的因素有喂养方式、添加辅食情况、家庭经济状况、人员构成、母亲文化程度等.结论:坚持母乳喂养,发展农村经济,提高父母文化程度,坚持科学育儿,是降低农村婴幼儿营养不良发生率的重要措施.     

实施出院随访对极低出生体重儿健康的影响研究

[目的]探讨实施出院随访能否降低极低出生体重儿疾病的发病率及病残率.[方法]对128例早产儿定期进行随访:前半年1个月～2个月随访1次,后半年2个月～3个月随访1次,以后半年随访1次.护士根据患儿家长不同的需求确定指导次数、内容,随时测量和记录患儿发育情况,并对未实施出院随访的患儿做了疾病发生率的调查.[结果]实施出院随访能降低婴幼儿疾病的发病率及病残率.[结论]出院随访可以减少早产儿各种疾病的发生,减轻家庭负担及社会负担.     

541例腹泻患儿轮状病毒感染的检测分析

[目的]本院住院腹泻患儿中轮状病毒（RV）的感染情况.[方法]收集本院2007年1月至2009年12月住院541例腹泻患儿粪便标本,采用胶体金标记金法检测A群RV.分析RV阳性患儿流行病学资料.[结果]541例中RV抗原检测阳性201例,阳性率37.15%.28 d至6个月、7至12个月、13至24个月3个年龄段RV检出率分别为36.65%、41.20%和35.56% RV腹泻抗原检出率年龄最高为6～12个月年龄段,达41.20% 全年中以11月至次年1月检出率最高,占全年66.67% 201例RV阳性患儿中合并呼吸道感染103例,占51.24%.[结论]年龄〈24个月婴幼儿是RV的易感人群 以11月至次年1月阳性检出率最高,合并呼吸道感染者居多.     

北京市东升镇社区6～36月龄婴幼儿贫血发病情况调查及相关影响因素分析

【目的】了解北京市东升镇辖区婴幼儿贫血的发病情况，探讨影响婴幼儿贫血的相关影响因素。【方法】测定2013年1～12月来社区卫生服务中心儿保门诊健康查体的1200例6～36月龄婴幼儿末梢血血常规，分析各年龄段贫血患病率。根据贫血情况分为贫血组（ n ＝410）与非贫血组（ n ＝790），收集2组幼儿的儿保资料，包括幼儿父母的文化程度、孕晚期孕母贫血史及严重程度、6个月内婴幼儿的喂养方式、添加辅食时间、辅食添加种类、婴幼儿断乳时间以及断乳后食品种类、婴幼儿既往贫血及治疗史等。分析影响婴幼儿贫血的相关因素。【结果】辖区6～36月龄婴幼儿贫血的总发生率为34．2％（410／1200）。其中轻度贫血为27．1％（325／1200），中度贫血为7．1％（85／1200），无重度贫血。6～12月龄婴幼儿贫血的发病率明显高于其他组。Logistic回归分析显示：父母文化程度、6个月内喂养方式以及是否适时合理添加辅食是婴幼儿贫血的影响因素。【结论】本辖区婴幼儿贫血总患病率仍较高，提高婴幼儿父母育儿知识、指导合理喂养并适时添加辅食是今后改善婴幼儿贫血的发展方向。     

微型营养评估法在心力衰竭病人中的应用研究

[目的]分析心力衰竭病人中营养不良及营养不良风险的发生率以及其可能对病人长期生存率的影响.[方法]对我科收治的368例诊断心力衰竭并出院的病人进行回顾性分析,在病人出院前进行数据采集,应用微型营养评估法对病人进行完整的营养评估,将病人分为营养良好,潜在营养不良及营养不良组.用Cox回归对可能影响预后的因素进行多因素分析.[结果]心力衰竭最常见的原因为心肌缺血（42％）,14.13％病人存在营养不良,59.78％的病人存在潜在营养不良,26.09％的病人营养良好;平均随访25个月,3组病人的死亡率分别为75.8％、34.7％和17.6％ （P＜0.001）;在Cox多因素分析中,营养不良是死亡率的独立危险因子（P＜0.001,OR=6.25,95％可信区间为3.03～12.87）.[结论]心力衰竭病人中营养不良及潜在营养不良发病率较高;营养不良是心力衰竭病人死亡的独立危险因素.     

b型流感嗜血杆菌疫苗不同接种部位对婴幼儿生理、行为状态的影响

[目的]观察不同接种部位接种b型流感嗜血杆菌疫苗对婴幼儿生理、行为能力的影响,选择合理的接种方式,降低不良反应发生率。[方法]选择两个免疫门诊2个月~18个月的婴幼儿接种b型流感嗜血杆菌结合疫苗1 599例,采用上臂三角肌中部和大腿前外侧(中1/3段)为接种部位,接种24h后进行电话回访,对影响程度进行统计学分析。[结果]两种受种部位婴幼儿生理反应比较,差异无统计学意义(P0.05);影响接种部位反应的因素主要为局部反应、活动受限。[结论]采用上臂三角肌中部为接种部位,有效地降低了不良反应发生率。     

萍乡地区婴幼儿喂养困难原因调查分析及对策研究

随机抽取萍乡市二个乡和二个社区作为调查及干预现场,以6~36个月龄婴幼儿喂养人作为调查对象,对其采用《婴幼儿喂养困难评分量表》(MCH-FS)中文版及《婴幼儿喂养问题影响因素调查表》进行问卷调查,对调查结果进行统计分析。472例婴幼儿中喂养困难122例(25.8%),其中轻度88例(72.1%)、中度20例(16.4%)、重度14例(11.5%);无喂养困难350例(74.2%)。婴幼儿喂养困难与年龄、父母健康情况、家庭饮食结构、父母平时饮食情况、延迟加辅食、喂养技巧及延长喂养明显相关(P0.05),与户籍、主要喂养人、父母文化程度、眼神交流无明显相关(P0.05)。萍乡地区婴幼儿喂养困难发生率为25.8%,其发生与较多因素相关,应针对不同原因指导婴幼儿喂养,以预防、减少喂养困难的发生。     

喉癌病人抑郁状态的相关因素调查与心理干预

[目的]探讨喉癌病人抑郁状态的发生率及其相关因素,为实施心理护理提供依据.[方法]采用Zung抑郁状态自评量表对208例喉癌病人进行问卷调查及相关因素分析.[结果]208例喉癌病人中,有81例存在抑郁,检出率为38.9%.其中轻度抑郁9.1%(19/208),中度抑郁24.5%(51/208),重度抑郁5.3%(11/208),平均随访40个月.无抑郁组生存期明显大于中度、重度抑郁组(P＜0.01).单因素分析显示病人的性别、疼痛程度、食欲状态、住院次数、经济情况因素对抑郁状态的发生有影响.[结论]应提高喉癌病人对癌症的认知水平,进行针对性的心理干预,从而降低抑郁状态的发生率.     

儿童抗结核药物肝毒性反应的相关因素分析

[目的]了解儿童抗结核药物致肝毒性反应的相关因素,为儿童结核病合理化疗提供依据.[方法]2002年1月至2006年12月在本院门诊或病房接受抗结核药物治疗的760例确诊儿童结核病患者,对其致肝毒性反应的相关因素进行分析.[结果]儿童结核惠儿在使用抗结核药物后出现肝毒性反应发生率为33.3%,肝毒性反应发生的相关因素有:年龄≤3岁、营养不良、使用含HRZ方案、静脉滴注INH等.[结论]儿童抗结核药物致肝毒性反应发生率高,3岁以下婴幼儿、营养不良、同时使用HRZ及大剂量和静脉滴注INH等其肝毒性反应的发生率明显增高.     

早产儿经PICC进行肠外营养的持续质量改进效果观察

目的:分析护理质量改进在经PICC进行肠外营养早产儿护理管理中的效果。方法:选择2013年1月至2018年12月在某三级甲等医院新生儿重症监护病房经PICC进行肠外营养的507例早产儿为研究对象,其中2013年1月至2015年12月收治的240例早产儿作为对照组,给予常规护理;2016年1月至2018年12月收治的267例早产儿作为观察组,实施改进后的护理措施。比较两组患儿在经PICC进行肠外营养期间,导管留置时间及相关并发症的发生情况。结果:观察组导管留置时间[19(12,29)d]长于对照组[16(11,22)d],具有统计学差异(Z=-2.947,P=0.003)。观察组发生PICC导管相关并发症发生率(2.25%)低于对照组(9.58%),具有统计学差异(χ^2=13.651,P<0.001)。结论:建立PICC专业管理小组,细化置管关键环节,加强感控管理等措施,可明显减少早产儿PICC导管相关并发症发生,延长导管使用时间,并有效提升早产儿肠外营养质量。     

抚触术对新生儿健康影响的临床研究

目的:观察抚触对新生儿健康的影响。方法:将200例正常足身月新生儿随机分为抚触组与对照组,对100 例抚触组新生儿进行抚触,每天2次,每次15min。对照组100例新生儿按常规护理,30d评估两组的各项指标。 结果:抚触组的新生儿头围、身长、体重,神经行为,经皮胆红素动态变化与对照组相比具有显著性差异(P≤0.01)。 结论:抚触术可促进新生儿的生长和神经行为的发育,减轻新生儿生理性黄疸程度。     

2005-2012年重庆市渝中区围产儿出生缺陷发生情况分析

目的通过回顾性研究分析重庆市渝中区2005-2012年围产儿出生缺陷的发生情况及变化趋势,为病因学研究提供线索,为孕前优生、遗传咨询、预防和降低出生缺陷再发风险提供参考依据,进一步提高出生人口素质。方法依据《中国出生缺陷监测方案》和《重庆市妇幼卫生监测方案》,对2005-2012年渝中区常住人口中分娩的围产儿进行监测,并分析主要指标。结果监测2005-2012年围产儿34 494例,出生缺陷592例,总出生缺陷发生率17.16‰。出生缺陷前3位依次为先天性心脏病、多指(趾)和唇腭裂。结论出生缺陷的水平和顺位与产前筛查和产前诊断等措施密切相关,通过进一步加强健康教育,做好婚前保健、孕产期保健,提高产前筛查及产前诊断水平,可降低围产儿出生缺陷的发生。     

营养风险及发育不良筛查工具在住院新生儿营养风险筛查中的应用

目的选择合适的营养风险筛查工具对新生儿进行营养风险评估。方法使用营养风险及发育不良筛查工具STRONGkid对98例住院新生儿进行营养风险筛查,并通过Fenton 2013生长曲线图从身长、体质量及头围等方面进行对比监测,评估新生儿的营养状况。结果总的营养风险检出率为67.3%(66/98),早产新生儿营养高风险的发生率较足月新生儿高(P0.05);总的营养不良检出率为52.0%(51/98),早产新生儿出营养不良的概率高于足月新生儿(P0.05)。营养风险检出率越高,则营养不良检出率也越高。结论营养风险及发育不良筛查工具STRONGkid的筛查结果可以为早期存在营养不良风险的新生儿进行营养干预提供参考。     

Palliative care in children in Wales: a study of provision and need

AIM: To establish incidence and prevalence of children needing palliative care in Wales. PATIENTS AND METHODS: Children were identified in three ways: (1) from paediatricians using the Welsh Paediatric Surveillance Unit (WPSU); (2) referrals to the specialist palliative medicine service based in Cardiff; and (3) children under the care of the two principal children's hospices serving Wales. All children referred or reported between January 2001 and December 2002 were included. RESULTS: A total of 226 children were identified. Fifty (22%) were identified by paediatricians, 58 (26%) were referred to the specialist paediatric palliative medicine service, 158 (70%) had been under the care of a children's hospice, and 34 (15%) were identified by more than one source. This study identified approximately 3.75 per 10000 children. This is about half the prevalence figures quoted in the ACT/ RCPCH document in 1997. CONCLUSIONS: The study may underestimate prevalence. Children needing palliative medicine are still under-recognized in Wales. The overlap between children's hospice care and specialist paediatric palliative medicine is relatively small.     

Health assessment in child care centers: parent and staff perceptions

PURPOSE: The purpose of this study was to identify preschool children's health needs in child care centers, as perceived by parents and staff. METHOD: A Health Care Services Assessment was completed by 55 parents and 13 staff in four urban child care centers to identify the health services needed and children's common health problems. FINDINGS: The majority (69%) of the parents and staff reported that onsite health services were needed at least once a week. Helpful health services were identified as screening exams for respiratory illnesses (88%), other illnesses (87%), developmental problems (51%), and children with special needs (50%). The most commonly identified child health problems were colds (93%) and ear infections (75%). CONCLUSION: These findings indicate that efforts to protect the health of preschool children in child care centers might best begin with health services focused on prevention, such as screening children for illnesses and providing information on infection control.     

室间隔缺损患儿术前的营养状况及其影响因素

目的探讨室间隔缺损患儿术前的营养状况及其可能的影响因素。方法采用便利抽样法,选取2011年5-12月在北京阜外医院就诊并接受室间隔缺损修补术的患儿143例,采用人体测量法、访谈法和问卷法调查患儿营养不良发生的情况及其影响因素。结果 (1)室间隔缺损修补术前患儿急性营养不良发生率为44.1%,慢性营养不良发生率为21.0%,总营养不良发生率为50.3%;(2)Logistic回归分析结果显示,患儿出生体质量、术前肺动脉压力水平、能量摄入情况及患儿母亲是否通过网络或图书获取营养知识是影响患儿术前营养状况的独立预测因素。结论室间隔缺损修补术前患儿营养不良发生率高,护理人员应全面评估患儿的出生体质量、术前肺动脉压力水平、能量摄入情况等,并有针对性地向高危患儿家属进行相关宣教,以改善患儿的营养状况,提高手术成功率。     

Malnutrition in a home‐living older population: prevalence,incidence and risk factors. A prospective study

Aims and objectives. To prospectively investigate and describe the prevalence and incidence of malnutrition among home‐living older people, related to demographic and medical factors, self‐perceived health and health‐related quality of life. Another aim was to find predictors for developing risk of malnutrition. Background. Risk factors for malnutrition have previously been identified as diseases, several medications, low functional status, symptoms of depression and inadequate nutrient intake. Most studies are cross‐sectionally performed at hospitals or in nursing care settings. Design. A prospective study with a sample of 579 home‐living older people, randomly selected from a local national register. Examinations were performed at baseline and yearly follow‐ups two to four times. Method. Questionnaires validated and tested for reliability, to detect risk of malnutrition (Mini Nutritional Assessment), symptoms of depression (Geriatric Depression Scale‐20), cognitive function (Mini Mental State Examination), health‐related quality of life (Nottingham Health Profile), well‐being (Philadelphia Geriatric Center Multilevel Assessment Instrument) self‐perceived health, demographic factors, anthropometry and biochemical examinations. Predictors were searched for through multiple logistic regression analysis with the MNA as dependent factor. Results. The prevalence of risk for malnutrition was 14·5%, according to the MNA. Two risk factors for malnutrition were lower handgrip strength and lower self‐perceived health. The incidence of risk for malnutrition at follow‐ups was between 7·6% and 16·2%. Predictors for developing malnutrition were higher age, lower self‐perceived health and more symptoms of depression. Men with symptoms of depression had a higher risk of developing malnutrition. Conclusion. Lower self‐perceived health had the highest power to predict risk for malnutrition, with increased number of depression symptoms and higher age as second and third predictors. Relevance to clinical practice. A regular and combined assessment using the Mini Nutrition Assessment, Geriatric Depression Scale‐20 and self‐perceived health as a base for identifying people in need, is one way to prevent the development of malnutrition.     

Co-bedding of twins in the neonatal intensive care unit

The increased incidence of multiple gestations has raised many questions regarding the differences in the care of twins versus singletons. The concept of co-bedding twins in the neonatal intensive care unit (NICU) has drawn increased attention in recent years. A NICU in a children's hospital in the Mid-Atlantic region of the United States explored the benefits and risks to this practice, and developed a guideline for double bunking twins. The guideline provides health care professionals with a safe and efficient means to arrange a physical environment that will simulate the environment many parents will use at home. Research is needed to determine the potential physical, psychologic, or psychosocial benefits of co-bedding multiple-gestation infants.     

Health Status of Children in Rural Areas of the Dominican Republic: Policy Implications for Nursing Practice and Nursing Education in Third World Countries

The major purposes of this study were to determine: the health problems of children in rural areas of the Dominican Republic; differences in types of child health problems in specific villages; and major areas nurses should emphasize in rural health programs for children. The sample consisted of 466 children, 5 years and younger, who were seen in clinics held in eight rural villages. The major health problems were protein-calorie malnutrition (66%), upper respiratory infections (58%), and otitis media (25%). There was a significant difference (p < .01) in the types of child health problems found in specific villages. The following areas should have high priority in health care programs for rural children: the nutritional needs of the child; the importance of breast-feeding; the use of available foods to achieve adequate protein; immunizations; and recognition of when to seek health care for the child. Policy recommendations for nursing practice and nursing education in Third World Countries focus on the provision of preventive health care programs for children in rural villages; reduction of malnutrition through educational programs; and the development of nursing education programs which are congruent with the health care needs of individuals in Third World Countries.