西部四县出院后早产儿管理模式比较研究  

Comparison study on management models of preterm infants of post-discharge in rural areas

作　　者：郝波[1] 周敏[1] 张小松[1] 赵更力[1] 王旭[1] 

机构地区：[1]北京大学第一医院妇产科,北京100034

出　　处：《中国儿童保健杂志》2016年第11期1145-1147,1159,共4页Chinese Journal of Child Health Care

基　　金：世界卫生组织项目(WPCH1409374)

摘　　要：目的比较不同管理模式下出院后早产儿管理率及家庭实施早期发育促进依从性(以下简称依从性)的差异,并探讨管理率及依从性的影响因素。方法采用方便抽样,选取广西及陕西各两个县,对研究地区一定时段出生的416例早产儿从出院后开始进行定期随访。广西对两县出生的146例早产儿采用分级分类管理,即县级妇幼保健院随访有高危因素的早产儿,乡卫生院随访其他早产儿;陕西由县级妇幼保健院负责随访两县出生的270例早产儿。两种模式实施的随访频率及内容均相同。结果县、乡分级分类管理组的早产儿管理率为86.3%,明显高于县级直接管理组的管理率57.0%(P<0.01);前者依从性也高于后者(P<0.01)。多因素分析结果显示,父母之一为看护人(OR=99.491)、早产儿有出生异常(OR=1.853),则管理率较高。父母之一为看护人(P<0.01)、家庭收入低(P<0.05)时依从性较好。结论在乡卫生院能够提供基本儿童保健服务的前提下,对出院后早产儿实施县、乡分级分类管理利于提高管理率及依从性。提倡父母参与早产儿养育及加强看护人的健康教育。Objective To compare visiting rates and the scores of early development promotion at home in two different management models for premature infants of post-discharge,and to explore possible associated factors. Methods In four sample counties from Shaanxi and Guangxi provinces in China,416 preterm infants were visited regularly since post-discharge.Management Modle one in Guangxi,the preterm infants with high risk factors were visited by doctors at county level and the others by doctors at township level.Management Modle two in Shaanxi,all preterm infants were visited by doctors at county level.In the 4counties,visiting intervals and contents were all unified. Results The visiting rates in Modle one was 86.3%,which was higher than that（57.0%）in Modle two（P〈0.01）;The scores of development promotion at home in Modle one were more than that in Modle two（P〈0.01）.Binary logistic and ordinal regression analysis showed that when parents as one of care givers（OR=99.491）or preterm infant having disease at birth（OR=1.853）,the visiting rates were higher and when parents as one of care givers（P〈0.01）or the less family＇s income（P〈0.05）,the scores of development promotion at home were more. Conclusions When preterm infants of post-discharge are classried and graded manageed by doctors at different levels,the visiting rates are higher and scores of early development promotion at home are more.The parents of preterm infants should be encouraged to raise their children by themselves.The health education should be improved for caregivers.

关 键 词：出院后早产儿管理模式 管理率 家庭早期发育促进依从性 

分 类 号：R179[医药卫生—妇幼卫生保健]