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目的:探讨高危儿健康综合管理模式,达到减少高危儿伤残、提高未来生活质量的目的。方法:采用横断面调查和查阅资料的方法,分析沈阳市儿童保健服务能力现状和高危儿筛查与干预率低的原因。结果:市、区(县)和社区卫生服务中心面积狭小,设备简单,儿童保健医生数量不足,工资待遇低,积极性不高,新知识更新培训不够,社区医院只能负责儿童生长发育门诊中体检、免疫注射和简单的口头指导。市级保健机构高危儿筛查率22%,在区(县)级妇幼保健机构和社区没有开设满足儿童保健需求的相应诊室,包括高危儿的筛查,大部分高危儿没有得到及时的干预,绝大多数的儿童保健服务项目属于空白。提出构建高危儿综合管理模式策略和对策,依托三级保健网络,建立一种以家庭为中心、以社区为基础、多学科协助参与,借助社会资本的投资,开展早期干预模式,可以使每个高危儿受益。结论:针对0~6岁儿童人生发展的关键时期,开展多学科、多部门联合的高危儿早期筛查和早期干预的综合管理模式,提高高危儿的学习能力及生活质量,促进儿童健康生存与发展。
Objective: To explore the integrated management model of high-risk infants, to reduce the risk of disability and improve the quality of life in the future. Methods: The cross-sectional survey and access to information on the analysis of the situation of children’s health care services in Shenyang City, screening and intervention of low-risk reasons. Results: The city, district (county) and community health service center are small in size, simple in equipment, lack in number of child health doctors, low salary, lack of enthusiasm and insufficient training of new knowledge renewal. The community hospital can only be in charge of physical examination in children growth and development clinic , Immunization and simple oral guidance. The screening rate of high-risk children in municipal-level health care institutions was 22%. At the district (county) level, MCH institutions and communities did not set up corresponding clinics to meet the needs of children’s health care, including the screening of high-risk children. Most high-risk children were not promptly interfered, The vast majority of child health services are blank. Put forward strategies and countermeasures for building integrated management mode of high-risk infants, relying on tertiary health care network, establishing a family-centered, community-based and multi-disciplinary assistance to participate, and using the investment of social capital to carry out the early intervention mode so that each High-risk children benefit. Conclusion: In view of the critical period of child development of children aged 0 ~ 6 years, the comprehensive management mode of early screening and early intervention of high-risk infants with multidisciplinary and multi-sectoral cooperation will be carried out to improve the learning ability and quality of life of high-risk infants and promote their healthy survival and development of.