高危儿监测的应用研究

Application study of monitoring high risk infants.

【目的】研究高危儿监测的方法和管理,以期能早期发现婴儿脑损伤,进行早期康复治疗,达到降低儿童残障发生率,提高儿童健康水平的目的。【方法】高危儿监测要解决监测方法和组织管理两个关键。通过高危儿家庭监测、高危儿筛查等方法,从高危儿人群中筛查发育临界儿,进行脑损伤的进一步诊断。家庭监测采用“高危儿家庭监测10条”,医疗保健门诊采用“高危儿筛查”5项检查。在各市县内依托原有的妇幼保健组织,建立“家庭-社区-医院”监测网,进行高危儿监测。【结果】在全省42个单位开展了高危儿监测工作。结果发现:发育临界儿297例中,由家长发现而就诊者46例,占15.5%,由门诊筛查发现者233例,占78.5%,由于明显异常表现而转诊或就诊者18例,占6.0%。首发地点为市县医院212例(71.5%),区乡医院39例(13.0%),家庭46例(15.5%)。近期疗效:显效149例,占50.2%,好转141例,占47.5%,无效7例,占2.3%,总有效率97.7%。【结论】高危儿监测技术是行之有效的适宜技术,在各级医疗保健机构可以实施的。通过技术培训,在各地建立“家庭-社区-医院”监测网,早期发现发育临界儿和进行早期医学干预,是降低婴儿脑损伤患病率、减少小儿残疾的一个重要途径。

[Objectives] To study the method and organization managements of the monitoring high risk infants and discover the infants with brain hurt in early days,so to carry earlytreatments. Attain to lower the disabled occurrence rate of child and raise the purpose of the children health level. [Methods] The monitoring high risk infants wants to solve to the methods of monitor and organization management. Pass these methods （including the family monitoring for high risk infants and sifting of high risk infants） looking up the infants with borderline child from the high risk infants crowd. Carry on further diagnosis of the brain hurt. Establishment ＂family-community-hospital＂monitor net of the of the high risk infants in each city and county,to Carry on monitoring high risk infants. [Results] The monitoring high risk infants have already been carried on in 42 hospitals of whole province. The result of monitoring high risk infants ：cure 297 examples patients with borderline child. The first discover but seek medical advice from the parent of have 46 examples （15.5 % ）,there are 233 examples （78.5 % ） discovered by out-patient service sifting high risk infants,there are 18 examples （6.0 % ）turned hospital because of obvious symptom. The location of the first time detection is the hospital city and county 212 examples （71.5%） ,is the hospital of the area country 39 examples（ 13.0% ）, is the family 46 examples（ 15. 5% ）. Comprehensive treatment in the near future curative effect ： show effect 149 examples （ 50.2 % ）, amendment 141 examples （ 47.5 % ）, invalid 7 examples（2.3%）,total efficient is 97.7%. [Conclusions] The technique monitoring high risk infants is an effectively feat technique（including the family monitoring high risk infants and the sifting high risk infants and early diagnosis of brain hurt etc. ）. It can carry out in the all levels hospital. After passing the technique training, built up ＂family-community- hospital＂monitor net everywhere. When carry on the early diagnosis and early treatment of borderline child, it is a path of reduce sequela of the brain hurts of infants.