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目的 了解西安市围生儿神经管畸形的发生及分布特征。方法 采用前瞻性研究方法 ,对西安市县级以上 111所医院出生的 4 2 2 72名围生儿进行监测。结果 西安市围生儿中神经管畸形的发生率为 2 37‰ ,单发神经管畸形占 87%。发生率最高的神经管畸形是脊柱裂 ,其他依次为无脑畸形、脑膨出、小头畸形。神经管畸形儿中有 17%伴有脑积水 ,其中有 2 7 5 9%脊柱裂儿伴有脑积水。乡村地区神经管畸形发生率与城镇间差别有显著性意义 (χ2 =10 92 3,P <0 0 5 ) ;不同性别神经管畸形发生差别无显著性意义 ;各季度间差别无显著性意义。产母年龄在 35岁以上为高发年龄。生育神经管畸形儿妇女有 71%为初中以下文化 ,有 75 %在产前已得到确诊 ,6 1%经济条件差 ,有 37%在孕早期有疾病史、服药史等。神经管畸形围生儿死亡率为 710‰ ,其中合并有脑积水的死亡率为 94 12 %。结论 西安市神经管畸形是围生儿死亡的主要因素 ,严重影响人口素质 ,要针对其分布特点 ,采取针对性的预防措施 ,降低神经管畸形的发生。
Objective To understand the occurrence and distribution of perineural neural tube defects in Xi’an. Methods A prospective study was conducted to detect 4222 72 infants born in 111 hospitals above the county level in Xi’an. Results The incidence of neural tube defects in perinatal children in Xi’an was 237%, and that of single neural tube defects was 87%. The highest incidence of neural tube defects were spina bifida, the other followed by anencephaly, encephalocele, microcephaly. 17% of children with neural tube defects have hydrocephalus, of which 275,9% have hydrocephalus. The incidence of neural tube defects in rural areas was significantly different from that in urban areas (χ2 = 10 92 3, P <0 05). There was no significant difference in the incidence of neural tube defects among different sexes. There was no significant difference between the quarters. Maternal age over 35 years of age for the high incidence. 71% of children with reproductive neural tube defects have junior high school education, 75% have been diagnosed in prenatal period, 61% have poor economic condition, and 37% have history of disease and medication history during the first trimester. Perinatal mortality in neural tube defects was 710 ‰, of which 94 12% was associated with hydrocephalus. Conclusion Neural tube deformity in Xi’an is the main cause of perinatal death, which seriously affects the quality of the population. According to its distribution characteristics, we take targeted preventive measures to reduce the incidence of neural tube defects.