CAJ | 학술논문

目的：分析早期家长育儿行为干预对婴幼儿血铅水平的影响及降低小儿铅危害的有效措施。方法于2011年6月至2013年2月，对西安交通大学医学院一附院儿保门诊行健康检查的小于2月龄西安市健康儿童342例进行研究，按照奇、偶编号将被研究儿童分为早期育儿行为干预组（实验组）和常规干预组（对照组）。对照组进行常规检查和喂养指导，实验组儿童家长分别在首次检查、6月龄、12月龄和18月龄时增加铅中毒相关知识及相关健康行为干预；按照知情自愿的原则，在20～24月龄时用原子吸收法检测两组婴幼儿静脉血铅含量，同时对主要喂养人进行相关知识的问卷调查。结果实验组儿童无铅中毒检出，对照组2例儿童被检出铅中毒，实验组儿童血铅水平为37．30±16．73μg／L，显著低于对照组儿童的43．31±22．01μg／L（ t＝2．85， P＜0．05），对两组儿童家长育儿行为进行比较，发现实验组在“避免孩子咬玩具、用湿式扫除、不用清晨水龙头第一壶水给孩子冲奶或做饭、重视孩子玩具的含铅情况”等方面优于对照组（χ2值分别为8．82、25．46、20．80和10．58，均P＜0．05）。 Logistic多因素分析显示，避免孩子咬玩具、不用清晨水龙头第一壶水给孩子冲奶或做饭，重视孩子玩具的含铅情况，均为影响血铅水平的保护因素，其OR值分别为2．378、2．136和1．699，均P＜0．05。结论早期对婴幼儿家长的育儿行为进行干预，与降低婴幼儿血铅水平有一定相关性。
목적：분석조기가장육인행위간예대영유인혈연수평적영향급강저소인연위해적유효조시。방법우2011년6월지2013년2월，대서안교통대학의학원일부원인보문진행건강검사적소우2월령서안시건강인동342례진행연구，안조기、우편호장피연구인동분위조기육인행위간예조（실험조）화상규간예조（대조조）。대조조진행상규검사화위양지도，실험조인동가장분별재수차검사、6월령、12월령화18월령시증가연중독상관지식급상관건강행위간예；안조지정자원적원칙，재20～24월령시용원자흡수법검측량조영유인정맥혈연함량，동시대주요위양인진행상관지식적문권조사。결과실험조인동무연중독검출，대조조2례인동피검출연중독，실험조인동혈연수평위37．30±16．73μg／L，현저저우대조조인동적43．31±22．01μg／L（ t＝2．85， P＜0．05），대량조인동가장육인행위진행비교，발현실험조재“피면해자교완구、용습식소제、불용청신수룡두제일호수급해자충내혹주반、중시해자완구적함연정황”등방면우우대조조（χ2치분별위8．82、25．46、20．80화10．58，균P＜0．05）。 Logistic다인소분석현시，피면해자교완구、불용청신수룡두제일호수급해자충내혹주반，중시해자완구적함연정황，균위영향혈연수평적보호인소，기OR치분별위2．378、2．136화1．699，균P＜0．05。결론조기대영유인가장적육인행위진행간예，여강저영유인혈연수평유일정상관성。
Objective To explore the influence of intervention on early family feeding on infants ’ blood lead level and the effective measures to reduce the hazard of lead .Methods From June 2011 to February 2013, 342 healthy infants ( <2 months old ) who took physical examination in child health clinic of the First Affiliated Hospital of Medical College of Xi ’ an Jiaotong University were selected and were further divided into early feeding intervention group ( experiment group ) and routine intervention group ( control group ) by odd and even number .The control group underwent routine checks and feeding guidance .The experiment group was additionally provided with knowledge and healthy behavior related with lead poisoning at the first visit , 6 months, 12 months and 18 months.With informed consent and voluntary principle , the blood lead levels of the studied infants were checked by atomic absorption and the major feeding people were surveyed on related information with questionnaires when infants were 20-24 months old.Results No lead poisoning was detected in the experiment group, while in the control group two cases were found with lead poisoning .The blood lead level was 37.30 ±16.73μg/L in the experiment group, which was significantly lower than that of the control group (43.31 ±22.01μg/L) (t=2.85, P<0.05).Comparison of the feeding behaviors of the parents indicated that the experiment group was better than the control group in the parents ’ behaviors of preventing infants from biting toys , wet wipe, not using the faucet water of early morning for cooking or milk mixturing for infants , and emphasizing on lead content of infants ’ toys (χ2 value was 8.82, 25.46, 20.80 and 10.58, respectively, all P<0.05).Multiple factor Logistic analysis showed that the above factors were the risk factors influencing blood lead level (OR value was 2.378, 0.987, 2.136 and 1.699, respectively, all P<0.05).Conclusion Intervention on early family feeding behaviors on infants is correlated with reducing blood lead level of infants .