山东省六月龄以下婴儿维生素K缺乏性出血症的流行病学调查

An epidemiological study on vitamin K deficiency bleeding in infants under six months

目的 了解山东省婴儿维生素K缺乏性出血症 (VKDB)的发病情况及影响因素。方法 采取分层整群随机抽样方法 ,抽取 5区 6县 2 815 6名活产婴儿 ,调查其 6个月内的出血情况 ,按照统一诊断标准进行诊断 ,VKDB病例与同期健康婴儿按 1∶2配对作病例对照分析。结果 VKDB总发病率为 3.2 7‰ ,农村 (4 .96‰ )高于城市 (1.19‰ ) ,VKDB病例多数为母乳喂养儿 (95 .5 7% ) ,早产儿VKDB发病率 (2 2 .5 2‰ )高于足月产儿 (2 .96‰ )。母亲妊娠期服药、婴儿出生窒息和生后 2周患病是VKDB的危险因素 ,出生后使用维生素K、非母乳喂养是保护性因素。结论 与国内同期调查相比 ,山东省为VKDB高发区。因此 ,预防工作极为重要 ,重点应放在农村、早产儿、母乳喂养儿和出生后患病的高危婴儿 ,要常规应用维生素K制剂。

Objective To understand the incidence and relevant affecting factors of infant vitamin K deficiency bleeding (VKDB) in Shandong Province Methods With stratified cluster sampling, 28 156 live newborns from five districts and six counties were surveyed for the condition of bleeding from their birth to 6 months based on standard diagnostic criteria. A 1∶2 matched case control study of VKDB was performed Results An overall incidence of VKDB was 3.27‰ in Shandong; higher in the rural areas(4.96‰)than in the urban areas(1 19‰).Most of the bleeding cases were breast fed babies(about 95.57%)and incidence of VKDB in pre term babies(22.52‰)was higher than that in term ones (2.96‰). Mothers' drug taking during pregnancy, asphyxia at birth, breast feeding and illness within two weeks after birth were risk factors for it. Use of vitamin K after birth and bottle feeding were protective factors for it Conclusions Incidence of VKDB is higher in Shandong Province, as compared to other areas all over the country at the same time period. It is very important to prevent VKDB, focusing on high risk babies in the rural areas, including those of preterm, breast fed and suffering illness after birth.