健康教育对轻中度铅中毒儿童干预作用的随机临床对照研究

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目的 评价健康教育对轻、中度儿童铅中毒的干预效果。方法 血铅水平在 10 0 μg/L以上的儿童 2 0 0名 ,随机分为 2组 :实验组 10 7名 ,对照组 93名。研究开始阶段 ,两组均要求儿童父母填写一份KABP问卷和家庭社会环境与健康问卷 ,随后对实验组采取健康教育进行干预 ,而对照组不采取任何措施。干预的时间为 3个月 ,随后对 2组的全部儿童进行血铅水平复测。结果 实验组干预后父母的铅中毒知识均有所提高 ,前后比较差异均有高度统计学意义 ;而对照组对儿童铅中毒的概念和预防知识也有部分提高。实验组在健康教育后 ,儿童及父母多种接触铅高危行为也有显著改善 ;而对照组只有少数改善。两组儿童血铅水平均有所下降 ,血铅下降值分别为 5 5 μg/L和 33μg/L ,具有统计学意义 (t=4 979,3 398,P <0 0 1) ;但实验组比对照组多下降 2 2 μg/L(t=3 5 31,P <0 0 1)。采用多元逐步回归分析排除可能的混杂因素后 ,有 14个变量最终进入血铅水平变化的逐步回归方程 ,这些变量有父母预防儿童铅中毒知识的提高、对儿童铅中毒态度的转变及儿童吃零食习惯的改变等。结论 对父母进行健康教育可明显提高家长对儿童铅中毒预防知识的了解 ,有效降低轻中度铅中毒儿童的血铅水平。健康教育可作为轻中度儿童铅中毒临床处理的 Objective To evaluate the intervention effect of health education on lead poisoning in light and moderate children. Methods 200 children with blood lead levels above 100 μg / L were randomly divided into two groups: 107 in the experimental group and 93 in the control group. At the beginning of the study, both groups asked their parents to fill out a questionnaire on KABP and family social environment and health questionnaire, followed by intervention in the experimental group with health education, while the control group did not take any measures. Interventions took 3 months, followed by a repeat blood lead level test for all children in both groups. Results After the intervention of experimental group, parents’ knowledge of lead poisoning was improved, with significant difference between before and after treatment, while the control group had some improvements on the concept and prevention of lead poisoning in children. In the experimental group, the risk of multiple exposure to lead by children and their parents also improved significantly after health education, while only a few improvements were found in the control group. Blood lead levels decreased in both groups, and the blood lead levels were decreased to 5 5 μg / L and 33 μg / L, respectively, with statistical significance (t = 4 979,3 398, P 0 01) Compared with the control group decreased by 2 2 μg / L (t = 3531, P <0.01). Using multivariate stepwise regression analysis to rule out possible confounding factors, 14 variables eventually entered a stepwise regression equation for changes in blood lead levels. These variables included parental prevention of childhood lead poisoning, changes in children’s attitude toward lead poisoning, and children’s snacking Changes in habits and so on. Conclusion Health education for parents can significantly improve the parents’ understanding of children’s lead poisoning prevention knowledge and effectively reduce the blood lead level of children with mild to moderate lead poisoning. Health education can be used as a mild to moderate lead poisoning clinical treatment
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