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目的:探讨出生缺陷三级干预管理在减少缺陷儿中的作用。方法:本研究于2008年1月~2012年12月对温岭市出生缺陷三级干预效果进行了统计分析,具体包括三级干预体系健全前(2008年)、健全后(2010年)、持续完善实施两年后(2012年)温岭市周岁内缺陷儿发生、出生变化情况及其干预效果。结果:通过对孕妇加强孕前干预,使得本地区婚检人数呈现逐年上升的趋势,而孕前优生检查人数也显著增加,而叶酸投放盒数则大幅度上升至24 722盒。通过加强对本地区孕后孕妇的干预,对比2008年和2012年的数据可以发现本地区孕妇接受血清学优生筛查、产前诊断人数逐年增加。而其中孕妇血清优生筛查的人数上升最明显(2.90倍),产前超声诊断增加2.63倍。这表明在怀孕后,孕妇对产前检查越来越重视。同期周岁内缺陷儿出生率由2008年的32.80‰下降到2012年的26.05‰。这说明通过健全的二级干预可以有效降低缺陷儿出生率。对比2008年和2012年的三级干预效果可以发现新生儿疾病筛查率由2008年的84.28%上升至2012年的99.50%。结论:加大健康教育宣教的力度,提倡婚前医学检查,加强围产期保健工作质量和出生缺陷三级干预管理是有效降低缺陷儿发生率、出生率和致残率的前提和保障。
Objective: To explore the role of tertiary management of birth defects in reducing defects. Methods: From January 2008 to December 2012, this study conducted a statistical analysis on the effect of tertiary intervention for birth defects in Wenling City, including the three levels before 2008 (2008), the sound (2010) and the continuous improvement Two years after implementation (2012), the incidence of birth defects in infants at the age of 5 in Wenling City and the effects of their interventions. Results: The premarital intervention for pregnant women increased the number of premarital examinations in the region and the number of prenatal checkups increased significantly. The number of folic acid delivery boxes increased significantly to 24,722 boxes. By strengthening the intervention of pregnant women in the region after pregnancy, the data of 2008 and 2012 can be found in pregnant women in the region to accept serological eugenics screening, the number of prenatal diagnosis increased year by year. Among them, the number of pregnant women with prenatal screening showed the most obvious increase (2.90-fold), and the prenatal ultrasound diagnosis increased 2.63-fold. This shows that after pregnancy, pregnant women pay more and more attention to prenatal care. During the same period, the birth rate of defective children dropped from 32.80 ‰ in 2008 to 26.05 ‰ in 2012. This shows that through a sound secondary intervention can effectively reduce the birth defects of children. Comparing the effect of the three interventions in 2008 and 2012, we can find that the screening rate of neonatal diseases increased from 84.28% in 2008 to 99.50% in 2012. CONCLUSION: Three-level intervention management, which is to increase the health education and education, promote premarital medical examination and improve the quality of perinatal health care work and birth defects, is the prerequisite and guarantee for effectively reducing the incidence, birth rate and disability rate of children with defects.