学龄前儿童口腔幽门螺杆菌感染影响因素及干预效果

Influencing factors for oral Helicobacter pylori infection in preschool children and effect of interventions

目的探索口腔干预对学龄前儿童口腔幽门螺杆菌感染的影响。方法选取2014年9月-2019年9月于杭州师范大学附属医院接受治疗的304例疑似口腔幽门螺杆菌感染患儿为研究对象,按照随机数表分为2组每组152例,试验组应用口腔干预,对照组应用常规口腔清洁措施。采用调查问卷收集口腔幽门螺杆菌感染患儿信息,对可能影响儿童发生口腔幽门螺杆菌感染的相关因素行单因素和多因素Logistic回归分析。采用13C尿素呼气试验及幽门螺杆菌唾液测试对幽门螺杆菌及口腔情况进行检查。结果干预前共检出212例唾液幽门螺杆菌阳性患儿,感染率为69.74%;干预后试验组口腔幽门螺杆菌感染阳性率低于对照组口腔幽门螺杆菌感染阳性率,差异具有统计学意义(P<0.05)。多因素Logistic回归结果显示,监护人饭前经常不洗手、儿童饭前便后经常不洗手、儿童爱啃手指是导致学龄前儿童口腔幽门螺杆菌感染的独立危险因素(P<0.05)。结论应该增加儿童饮食健康教育宣传,提倡使用公筷及家庭分餐制,儿童就餐时应该注意个人卫生,定期使用生物溶菌酶牙膏进行口腔清洁,确诊为口腔幽门螺杆菌感染后及时就医,降低发生其他并发症的可能性。

OBJECTIVE To explore the effects of oral intervention on oral Helicobacter pylori infection in preschool children. METHODS A total of 304 children with suspected oral H. pylori infection who were treated in the affiliated hospital of Hangzhou Normal University from Sep. 2014 to Sep. 2019 were recruited as the research subjects. They were divided into two groups according to the random number table, 152 patients in each group. Intervention was performed in the research group and patients in the control group were applied by routine oral cleaning measures. A questionnaire was used to collect information on children with oral H. pylori infection;single-factor analysis and multi-factor logistic regression analysis were used to find the related factors that may affect oral Helicobacter pylori infection in children. 13 C urea breath test and H. pylori saliva test were used to detect Helicobacter pylori and oral conditions. RESULTS A total of 212 cases of salivary H. pylori positive children were detected before the intervention in this study, and the infection rate was 69.74%. After the intervention, the positive rate of oral H. pylori infection in the test group was significantly lower than that in the control group(P<0.05). Multivariate logistic regression analysis showed that guardians without washing their hands before meals, children wihout washing their hands before meals, and children chewing their fingers were the independent risk factors of oral H. pylori infection in preschool children(P<0.05). CONCLUSION Dietary health education in children should be noticed and widely publicized. Public chopsticks and spoon should be used and the individual Dining system should be proposed. Children should pay attention to personal hygiene when they eat meals and use biolysozyme toothpaste for oral cleaning periodically. After being diagnosised of oral H. pylori infection, they should seek medical treatment in time to reduce the occurrence of other complications the possibility of illness.