加强随访管理对改善社区6~12月龄婴儿轻度贫血的效果研究

Effect of intensive follow-up on correction of mild anemia among infants in community

目的探讨加强随访管理对改善社区6~12月龄婴儿轻度贫血的效果。方法2016年4月至2017年1月,选择在常州市兰陵街道社区卫生服务中心儿保门诊接受系统管理的6~12月龄轻度贫血患儿84例为研究对象,完成研究者75例,简单随机法分为试验组(36例)和对照组(39例)。实验组给予加强随访管理,对照组给予常规系统管理,随访2和6个月,比较两组血红蛋白(Hb)值、Hb变化值、贫血纠正率、结案率,以及两组铁剂治疗患儿的服药情况、Hb值。结果随访2个月时,试验组Hb值[(113.50±5.40)g/L比(109.13±7.91)g/L,t=2.772,P=0.007]、Hb变化值[(13.22±4.56)g/L比(7.54±6.75)g/L,t=4.240,P<0.001]、贫血纠正率[77.8%(28/36)比46.2%(18/39),χ^2=6.617,P=0.010]均显著高于对照组;随访6个月时,试验组Hb值[(116.22±3.72)g/L比(112.23±5.90)g/L,t=3.471,P=0.001]、贫血纠正率[88.9%(32/36)比66.7%(26/39),χ^2=4.082,P=0.043]及结案率[77.8%(28/36)比41.0%(16/39),χ^2=8.967,P=0.003]均显著高于对照组。对接受铁剂治疗的患儿,随访2个月时,试验组规范用药比例显著高于对照组(14/14比4/8,χ^2=5.525,P=0.019);随访2和6个月时,试验组Hb值均显著高于对照组[随访2个月时:(109.93±3.51)g/L比(102.88±2.88)g/L,t=4.820,P<0.001;随访6个月时:(114.50±4.00)g/L比(108.55±5.04)g/L,t=3.297,P=0.003]。结论提示加强随访管理可显著提高社区6~12月龄轻度贫血患儿的Hb水平、贫血纠正率和结案率。

Objective To investigate the effect of intensive follow-up on the correction of mildanemia among infants in the community. Methods Eighty four infants aged 6-12months with mild anemiamanaged systematically in the child health clinic of Changzhou Lanling Community Health Service Centerwere enrolled from April 2016 to January 2017. Seventy five cases completed the study, including 36 casesmanaged with intensive follow-up (study group) and 39 cases managed with routine procedure (control group). Thehemoglobin(Hb) levels, Hb changes, the rates of correction and closure of anemia and the medication of irontreatment were compared between two groups during the 2 and 6 month-follow-up. Results The Hb value,Hb changes, the rate of correction in study group were significantly higher than those in control group after 2monthsof treatment [(113.50±5.40)g/L vs. (109.13±7.91)g/L, t=2.772, P=0.007; (13.22±4.56)g/L vs. (7.54±6.75)g/L, t=4.240, P<0.001; 77.8%(28/36) vs. 46.2%(18/39), χ^2 =6.617, P=0.010, respectively]. In 6 month-follow-up, the Hb value, the rate of correction and closure rate in study group were significantly higher thanthose in control group [(116.22±3.72)g/L vs. (112.23±5.90)g/L, t=3.471, P=0.001; 88.9%(32/36) vs. 66.7%(26/39), χ^2 =4.082, P=0.043; 77.8%(28/36) vs. 41.0%(16/39), χ^2 =8.967, P=0.003, respectively]. For infantsreceiving iron treatment, the proportion of standardized medication in study group was significantly higher thanthat in control group after 2 months (14/14 vs. 4/8, χ^2 =5.525, P=0.019); the Hb values in study group were significantly higher than those in control group after 2 months[ (109.93±3.51)g/L vs. (102.88±2.88)g/L, t=4.820, P<0.001)and 6 months[(114.50±4.00)g/L vs. (108.55±5.04)g/L, t=3.297, P=0.003] of follow-up. ConclusionThe intensive follow-up management can significantly improve the Hb values, the rates of correction and closurerate of infants with mild anemia in the community.