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目的探讨岳阳市增补叶酸预防神经管缺陷(NTDs)项目管理的新思路、新模式,促进增补叶酸预防NTDs工作全面发展。方法根据岳阳市2012-2015年妇幼卫生年报增补叶酸预防NTDs项目资料进行分析,选取2012年1-12月领取叶酸的妇女作为对照组,2013年1月-2015年12月领取叶酸的妇女为研究组,比较增补叶酸预防NTDs项目路径管理新模式前后实施效果。结果研究组新增叶酸服用率、服用依从率、叶酸知识知晓率都较对照组升高,分别由90.64%、78.35%、87.81%增长至95.95%、86.96%、95.70%。死胎及死产率、NTDs发生率则较对照组降低,分别由3.14‰、1.82/万降至2.24‰、1.06/万。结论保健路径管理新模式实施后,通过制定全市叶酸发放流程、加强培训和宣传、建立质控体系等措施有效地提高了增补叶酸实施成效,减少了出生缺陷,改善了妊娠结局。真正做到保障母婴健康,提高出生人口素质,促进增补叶酸预防NTDs工作进一步发展。
Objective To explore new ideas and new models for the management of NTDs in Yueyang and to promote the comprehensive development of NTDs by folic acid supplementation. Methods Based on the data of folic acid supplementation with NTDs supplemented by annual report of MCH in Yueyang City from 2012 to 2015, the women who took folic acid from January to December in 2012 were selected as the control group. Women who took folic acid from January 2013 to December 2015 were selected as the study materials Group, comparing the effect of adding folic acid to prevent NTDs project path management before and after the implementation of the new model. Results The rate of new folic acid intake, taking compliance rate and knowledge of folic acid in the study group were all higher than those in the control group, increasing from 90.64%, 78.35% and 87.81% to 95.95%, 86.96% and 95.70% respectively. The stillbirth and stillbirth rate, NTDs incidence was lower than the control group, from 3.14 ‰, 1.82 / million down to 2.24 ‰, 1.06 / million. Conclusion After implementing the new mode of health care path management, measures such as establishing the whole city folic acid dispensing process, strengthening training and publicity and establishing quality control system have effectively improved the effectiveness of folic acid supplementation, reduced birth defects and improved pregnancy outcomes. To truly protect the health of mothers and infants, improve the quality of the population born, and promote the further development of folic acid supplementation prevention NTDs.