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目的 了解山东省婴儿维生素K缺乏性出血症 (VKDB)的发病情况及影响因素。方法 采取分层整群随机抽样方法 ,抽取 5区 6县 2 815 6名活产婴儿 ,调查其 6个月内的出血情况 ,按照统一诊断标准进行诊断 ,VKDB病例与同期健康婴儿按 1∶2配对作病例对照分析。结果 VKDB总发病率为 3.2 7‰ ,农村 (4 .96‰ )高于城市 (1.19‰ ) ,VKDB病例多数为母乳喂养儿 (95 .5 7% ) ,早产儿VKDB发病率 (2 2 .5 2‰ )高于足月产儿 (2 .96‰ )。母亲妊娠期服药、婴儿出生窒息和生后 2周患病是VKDB的危险因素 ,出生后使用维生素K、非母乳喂养是保护性因素。结论 与国内同期调查相比 ,山东省为VKDB高发区。因此 ,预防工作极为重要 ,重点应放在农村、早产儿、母乳喂养儿和出生后患病的高危婴儿 ,要常规应用维生素K制剂。
Objective To investigate the incidence and influencing factors of vitamin K deficiency hemorrhage (VKDB) in Shandong province. Methods A stratified cluster random sampling method was used to collect 2 815 6 live births from 6 counties in 5 districts and to investigate the bleeding within 6 months. According to the uniform diagnostic criteria, VKDB cases were matched with healthy infants at 1: 2 Paired as a case-control analysis. Results The overall incidence of VKDB was 3.2 7 ‰, that of rural (4.96 ‰) was higher than that of urban (1.19 ‰), that of VKDB was mostly breast-fed (95.57%), and that of VKDB 2 ‰) than full-term infants (2.96 ‰). Mother taking medication during pregnancy, infant asphyxia and 2 weeks after birth are risk factors for VKDB. Vitamin K is used after birth, and non-breastfeeding is a protective factor. Conclusion Compared with the same period of domestic survey, Shandong Province is the high incidence area of VKDB. Preventive work is therefore of paramount importance, with emphasis on rural, preterm, breastfeeding and high-risk infants who become ill at birth, with routine use of vitamin K preparations.