贵州农村新生儿溶血症群体技术干预效果示范研究

Demonstration study on intervention effect of group technique for neonatal hemolytic disease in rural areas in Guizhou province

目的:探索贵州农村新生儿溶血症群体干预的有效策略和方法。方法:采用人群预防实验研究方法,在干预县建立示范区,引入新生儿溶血症干预技术进行一年的现场干预。通过对实验区和对照区地区间及干预前后的结果比较,了解新生儿溶血症干预的实施效果。结果:研究共纳入15 795名计划怀孕或已孕妇女作为研究对象,开展新生儿溶血症干预研究,其中干预组8 216人,对照组7 579人;开展血型筛查7 762人,筛查率94.47%;发现高危夫妇659对,其中怀孕615人;开展高危对象孕期B超监测603人,监测率98.05%;高危孕妇血清IgG抗A(B)效价92例;产后访视高危对象615名,访视率100.00%;干预组未发生因新生儿溶血症和母子血型不合高胆红素血症死亡病例,对照组因新生儿溶血症死亡2例,母子血型不合高胆红素血症死亡1例。结论:群体干预技术能够明显降低新生儿溶血症发病率。

Objective： To explore the effective strategies and methods for group invention of rural neonates with hemolytic disease in Guizhou province. Methods： Population prevention experimental study method was used in the study, demonstration area was established in intervention country, site intervention was conducted for one year though the introduction of intervention techniques for hemolytic disease of newborn. The implementation effect of intervention techniques for hemolytic disease of newborn was understood by comparing the results be- tween experimental area and control area before and after intervention. Results： A total of 15 795 women planning to get pregnancy or preg- nant women were enrolled in the study as study objects, then intervention study for hemolytic disease of newborn was performed, 8 216 women in intervention group and 7 579 women in control group were included ; a total of 7 762 women received blood group screening, the screening rate was 94. 47% ; 659 high risk couples were found, including 615 pregnant women; 603 high risk cases received ultrasonic moni- toring during gestatJonal period, the monitoring rate was 98. 05% ; 92 high risk pregnant women participated in the monitoring of serum IgG anti -A （B） titer; 615 high risk cases were found during postpartum visit, the rate was 100. 00% ; there was no neonatal death induced by neonatal hemolytic disease and hyperbilirubinemia because of maternal - fetal blood group incompatibility in intervention group, while in con- trol group, two neonates died because of neonatal hemolytic disease, and one neonate died because of hyperbilirubinemia induced by mater- nal-fetal blood group incompatibility. Conclusion： Population intervention technique can reduce the incidence of neonatal hemolytic disease significantly.