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目的 评估出生后早期佝偻病预防的方法。方法 以医院为基础 (Hospitalbased)的双盲随机对照试验方法 ,对 149例新生儿单次给维生素D疗法 (对照组 15 6例 )的预防效果进行了评估。结果 ①预防组的骨碱性磷酸酶 1月龄和 3月龄异常率较对照组显著降低 ,预防组的 3月龄颅骨软化发生率显著降低。②预防组的上呼吸道感染发生率在 3月龄和 10月龄时较对照组显著降低。③预防组的 3月龄和 10月龄身长较对照组稍高(有统计学差异 )。④预防组发生惊厥和可疑惊厥病例稍多 ,但尚无统计学显著意义 ,两组发生惊厥和可疑惊厥病例的血钙基本正常。⑤经检查 :失访率较低 (<6 % ) ,分组后的均衡性较好 ,查体的重复性较好 (Kappa值 >0 75 )。⑥初步的卫生统计学分析提示 :本方法的NNT为 12人 ,每预防 1例佝偻病约需人民币 2 0元 ,每减少 1个生命质量调整寿命年损失约需人民币 6 6 7元。结论 出生后单次预防有一定的可行性。
Objective To assess the prevention of rickets in the early postnatal period. Methods A double-blind, randomized, controlled, hospital-based approach was used to evaluate the prophylactic efficacy of 149 singleton doses of vitamin D (n = 156 in the control group) neonates. Results ① The abnormalities of 1-month-old and 3-month-old bone alkaline phosphatase in the prevention group were significantly lower than those in the control group, and the incidence of 3-month-old skull softening in the prevention group was significantly decreased. ② The incidence of upper respiratory tract infection in the prevention group was significantly lower than that in the control group at 3 months and 10 months of age. (3) The 3-month-old and 10-month-olds of the prevention group were slightly higher than the control group (with statistical difference). ④ There were a little more cases of convulsions and suspicious convulsions in the prevention group, but there was no statistically significant significance. The blood calcium in the two groups was basically normal in patients with convulsions and suspicious convulsions. ⑤ after examination: lower follow-up rate (<6%), better balanced after grouping, physical examination was better (Kappa value> 0 75). ⑥ preliminary analysis of health statistics suggest that: The method of NNT for 12 people, prevention of 1 case of rickets for about prevention of a disease of about 20 yuan, for each reduction in the life of a life expectancy of about 667 yuan loss. Conclusion Single birth prevention after a certain feasibility.