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目的观察铁剂补充结合喂养指导的综合干预对离乳期营养性贫血儿童的血红蛋白浓度升高和贫血纠正的效果。方法对2012年5月河北省赵县两个乡镇体检发现的6~11月龄营养性贫血(Hb<110g/L)的儿童分别入选干预组和对照组,两组分别有136名和87名儿童完成了全程随访,两组儿童都接受常规补充铁剂3个月。干预组每月由卫生室的医生提供一次家长离乳食指导。分别在1、3、12个月后复查儿童血红蛋白浓度和评估离乳食期喂养。结果相对于入选时,随访时干预组和对照组的儿童自身血红蛋白浓度上升,3个月随访时分别为(14.85±14.85)g/L和(8.07±12.90)g/L,12个月随访时分别为(17.17±16.44)g/L和(5.77±13.87)g/L;各组每次随访时的上升值皆有统计学意义(P=0.000);两次随访时干预组的上升值高于对照组,皆有统计学意义(P=0.002和0.000)。干预组和对照组儿童的贫血纠正率在3个月随访时分别为52.2%和32.3%(P=0.004),12个月随访时为56.6%和31.0%(P=0.001)。相对于对照组的常规措施,干预组的离乳食干预对纠正儿童贫血的关联强度(RR)在3、12个月时分别为1.62和1.83,归因危险度(AR)分别为19.9%和25.6%。结论在我国农村地区对离乳期营养性贫血的儿童进行喂养指导干预,短期内能够促进补铁治疗效果,而且通过长久影响儿童的营养状况,在补铁停止之后持续稳定纠正和预防儿童贫血,对婴幼儿营养改善具有长期意义。
Objective To observe the effects of iron supplementation combined with feeding guidance on hemoglobin concentration and anemia correction in children with nutritional anemia. Methods Children aged 6 ~ 11 months with nutritional anemia (Hb <110g / L) detected in two townships in Zhao County, Hebei Province in May 2012 were enrolled in the intervention group and the control group, 136 and 87 children Complete the whole follow-up, two groups of children received routine iron supplementation for 3 months. The intervention group provided a monthly parental leave instruction from a clinic doctor. Children were reviewed for hemoglobin concentration after 1, 3, and 12 months, respectively, and assessed for lactation feeding. Results Compared with those at follow-up, the hemoglobin concentration of children in the intervention group and the control group increased at the follow-up period of (14.85 ± 14.85) g / L and (8.07 ± 12.90) g / L at the 3-month follow-up (17.17 ± 16.44) g / L and (5.77 ± 13.87) g / L, respectively. There was a statistically significant increase in each follow-up in each group (P = 0.000). In the two follow-up groups, In the control group, both were statistically significant (P = 0.002 and 0.000). The rates of anemia in intervention and control groups were 52.2% and 32.3% at 3 months of follow-up (P = 0.004), 56.6% and 31.0% at 12 months of follow-up (P = 0.001). Relative to the usual measures in the control group, the correlative strength (RR) of the intervention group’s lactation intervention to correct childhood anemia was 1.62 and 1.83 respectively at 3 and 12 months, and the attributable risk (AR) was 19.9% and 25.6%. Conclusion Guiding intervention for feeding off-stage nutritional anemia in rural areas in our country can promote the effect of iron supplementation in a short period of time. And through long-term impact on the nutritional status of children, we continue to stably correct and prevent childhood anemia after iron supplementation is stopped, Long-term significance for infant nutrition improvement.