上海市部分幼儿园学龄前儿童低体重影响因素分析

Influencing factors of underweight in children from some kindergartens in Shanghai

目的分析5~6岁学龄前儿童低体重的影响因素,为儿童低体重的预防和干预提供科学理论基础与依据。方法采用整群抽样对照研究的方法,对上海市10所幼儿园低体重儿童进行体格测量和家长自填式问卷调查,使用多因素Logistic回归分析其影响因素。结果学龄前儿童低体重的发生主要与家庭行为、儿童饮食行为习惯有关。其中无人陪同吃早饭(OR=2.543,95%CI:1.251~5.169)、爱挑食(OR=1.096,95%CI:1.096~2.800)、边吃边玩(OR=1.257,95%CI:1.257~3.199)为学龄前儿童低体重的独立危险因素;吃饭咀嚼充分(OR=0.183,95%CI:0.049~0.680)、园外活动类型动静结合(OR=0.800,95%CI:0.649~0.986)为低体重的保护性因素。结论 5~6岁儿童低体重的发生是多种因素综合作用的结果,其中儿童不良进食行为占主要因素,培养儿童良好的用餐行为有助于改善学龄前儿童低体重,改善体质,减少营养不良情况的发生。

Objective To investigate the main risk factors and pathogen distribution of preterm infants with nosocomial bacterial sepsis. Methods Totally 87 preterm infants with nosocomial bacterial septicemia from the Neonatology Department of the Maternal and Child Health Hospital Affiliated to Nanjing Medical University were recruited from May,2008 to April,2017.High risk factors and pathogens of sepsis were analyzed. Results The prevalence of preterm infants with nosocomial bacterial sepsis was 1.20%（87/7 221）.The major pathogens of the infections among these premature infants included gram-positive bacteria（70.8%）,especially staphylococcus epidermidis（33.3%）,and gram-negative bacteria （29.2%）,especially Klebsiella pneumoniae （42.3%）.Logistic regression analysis showed that the very low birth weight（OR=1.9,95%CI：0.9～5.3,P=0.013）,indwelling peripherlly inserted central catheter （PICC）（OR=3.3,95%CI：2.5～8.3,P=0.006）,tracheal intubation （OR=2.3,95%CI：1.7～5.7,P=0.001） and twins （OR=1.5,95%CI：0.7～4.2,P=0.009） were high risk factors of preterm infants with nosocomial bacterial sepsis. Conclusion The very low birth weight,indwelling PICC,tracheal intubation and twins are high risk factors of neonates with nosocomial bacterial sepsis,whereas the leading pathogen is staphylococcus epidermidis.