深圳福田区流动人口高危儿卫生保健现状分析

An investigation of current situation of health care for high-risk infants in floating population in Futian district of Shenzhen city

目的 了解流动人口高危儿发生情况、高危儿生长发育监测及早期干预等卫生保健服务现状,为受流动因素影响的高危儿提供可行的卫生保健服务管理方案.方法 分层随机整群抽取深圳市福田区3家辖区医院,从2008年出生的活产新生儿中筛查出高危儿,并随机抽取260例高危儿调查体格发育、神经发育监测及早期干预情况.结果 流动人口高危儿发生数为584例,常住人口发生数为56例,最主要的高危因素是早产103（17.64）、宫内窘迫101（17.29）;流动人口高危儿系统体格检查人数与常住人口高危儿系统体检人数相比,两者差异有统计学意义（χ^29.815,P〈0.05）,发育评价差异有显著性（χ^26.200,P〈0.05）;接受神经发育监测人数相比,两者差异有统计学意义（χ^218.056,P〈0.05）.结论 深圳市福田区流动人口高危儿系统体检、神经发育监测率低.应提高流动人口卫生保健意识,以社区医疗服务为中心,建立以＂社区-医院＂相结合的管理模式,减少高危儿伤残,提高人口素质.

Objective To investigate current situation of health care services for high-risk infants （HRIs） in floating population, including incidence of HRIs, monitoring of growth and development of HRIs and early intervention for them, so as to provide basis for working out a feasible management program of health care services for these floating infants. Methods In stratified random cluster sampling method, HRIs were screened out from all live neonated born in three district-level hospitals in Futian district in 2008, and 260 HRIs were extracted and investigated for monitoring situations of their physical and neural development and early intervention for them. Results 584 HRIs were diagnosed in floating population, while 56 HRis were found in persistent resident population. The major high-risk factors were premature labor and fetal distress. The proportion of HRIs who received systemic physical and neural developmental examination in floating population was lower than that in the persistent resident population, of which, the main reasons why the floating population didn ＇ t accept neurodevelopmental monitoring were unwilling to transfer to another hospitals and thinking that the neurodevelopmental surveillance was unnecessary. Conclusion The incidence of HRIs in the floating population is much higher than that in persistent resident population in Futian district, Shenzhen city, so the floating population is a high-risk population who need to be paid more attention. The resources of health care service for HRIs in floating population is not fully utilized. In order to reduce incidence of disability and improve population quality, it is necessary to enhance awareness of health care of floating population and to build an administration mode of ＂communityhospital combination＂ on the basis of taking community health care services as dominant work.