克拉玛依市在医院出生的新生儿首剂乙型肝炎疫苗未及时接种原因分析

目的分析克拉玛依市在医院出生的新生儿首剂乙型肝炎疫苗（First Dose Hepatitis B Vaccine，HepB．）未及时接种的原因，为提高新生儿HepB，及时接种率提供参考。方法采取回顾性调查分析方法，系统收集克拉玛依市2004～2010年所有在医院出生的新生儿的HepB，接种资料，对未及时接种HepB，的原因进行分析。结果克拉玛依市2004～2010年在医院出生的新生儿共20159人，HepB，及时接种率95．19％；不同年份HepB，及时接种率的差异有统计学意义（z。=289．29，P〈0．01）；不同地区在医院出生新生儿HepB，及时接种率的差异无统计学意义（X^2=2．84，P〉0．05）；在不同医院出生的新生儿HepB，及时接种率的差异有统计学意义（X^2=121．54，P〈0．01）。在医院出生的新生儿未及时接种HepB．的主要原因是新生儿疾病，占34．98％；其次为早产占26．73％，低体重占20．23％，窒息占13．31％，监护人拒绝接种和自动离院占4．75％。结论影响克拉玛依市在医院出生的新生儿HepB。未及时接种的主要原因是接种人员对HepB，接种禁忌证的把握过度严格，应加强对接种人员相关知识的培训，提高在医院出生新生儿的HepB，及时接种率。

Analysis of First Dose Hepatitis B Vaccine Coverage and Causes of Not Timely Vaccination among theNeonatal Born in the Hospital

Objective To understand the first dose hepatitis B vaccine （HepB1） coverage and reasons of not timely vaccination among the newborn born in hospital in Karamay city and to provide the scientific basis for improving HepB1 coverage. Methods To collect HepB1 coverage data of the newborn born in hospital during 2004-2010 and not timely vaccination causes by the method with a retrospective survey. Results During 2004 - 2010, there were 20,159 neonatal born in hospital. Timely HepB1 coverage was 95.19%. There were significant statistical difference in timely HepB1 coverage among the neonatal born in hospitals （X^2= 289.29, P 〈0.01 ）, there were no significant statistical difference in timely HepB1 coverage among children born in different districts （Z2 = 2.84, P〉 0.05）. There were statistical difference on timely HepB1 coverage （X^2= 121.54, P 〈0.01 ） among children born in different hospital. Among the neonatal bornin hospital with not timely vaccination, the main cause was neonatal disease which account for 34.98 %, premature birth was 26.73%, low birth weight was 20.23%, asphyxia was 13.31%, guardian refuse to get HepB and automatically left from the hospital was 4.75%. Conclusions The main cause for not timely vaccination of HepB1 among the neonatal born in hospital in karamay city was that the staff did not correctly handle the HepB1 vaccination contraindiction. It was important to strengthen training for the staff on knowledge of HepB vaccination in order to improving the timely HepB1 coverage among the neonatal born in hospital.