新生儿卡介苗接种情况及护理对策

Neonatal BCG vaccination and nursing strategies

目的了解深圳某大型综合性医院出生新生儿卡介苗接种、未接种原因及疑似预防接种不良反应的发生情况，并提出护理对策。方法收集2010至2012年深圳市人民医院出生新生儿卡介苗接种及疑似不良反应报告资料。结果2010—2012年深圳市人民医院出生18692名新生儿，新生儿卡介苗接种率为94．4％，随着年份增加，卡介苗接种率有逐年升高的趋势，差别有统计学意义（X2=17．67，P=0．000）。三年中仅发生1例一般反应（发热为38．7℃）。三年在医院住院期间有1056人未接种卡介苗，未接种原因主要是早产、低体重、新生儿窒息，分别占61．1％、21．2％、10．2％，还有呼吸困难、黄疸、畸形、贫血、先天性心脏病等共占7．5％。结论深圳市人民医院住院分娩的新生儿卡介苗接种率较高，疑似预防接种不良反应发生率较低，未接种原因主要是对禁忌症把握过严，需加强预防接种工作人员的培训。

Objective To understand neonatal BCG vaccination, reasons for unvaccination, and rate of adverse events following immunization （AEFI） in newborns at a large general hospital in Shenzhen. Methods The data on immunizaion and AEFI were collected in Shenzhen People＇ s Hosptial from 2010 to 2012. Results 18,692 neonates were born in Shenzhen People＇ s Hosptial. The rate of BCG vaccination was 94.4% and it increased year by year （X 2= 17.67, P = 0.000）. The general reaction occurred in one patient （fever of 38.7℃） within three years. In the 1,056 newborns who unvaccinated BCG, the reasons for unvaccintion were premature birth （61.1%）, low birth weight （21.2%）, neonatal asphyxia （10.2%）, and other conditions including difficulty breathing, jaundice, deformities, anemia,and congenital heart disease （total 7.5%）. Conclusions The rate of BCG vaccination is higher in Shenzhen People＇ s Hospital, and the rate of AEFI is lower. The major reason for unvaccintion is overly strict contraindications. Training should be strengthened in the staff responsible for vaccination.