2022-2024年深圳市福田区危重症孕产妇流行病学特征及相关因素分析

Analysis of Epidemiological Characteristics and Related Factors of Critically Ill Pregnant Women in Futian District, Shenzhen (2022–2024)

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摘要:目的 分析2022—2024年深圳市福田区危重症孕产妇不同亚组(不同并发症/合并症)的流行病学特征、病因构成及相关因素,为优化区域孕产妇健康管理提供依据。方法 基于福田区危重症孕产妇监测网络,对2022年1月1日至2024年12月31日期间107921例孕产妇个案资料进行回顾性描述性分析,采用描述性流行病学方法及卡方检验分析不同因素与危重症主要并发症的关联。结果 深圳市福田区3年间危重症孕产妇共729例,总体发生率为6.75‰。各年度发生率分别为2022年6.67‰、2023年7.38‰和2024年6.33‰。危重症孕产妇中,≥35岁者占33.7%,本科及以上学历者占53.8%。初检妊娠风险评级为黄色者占比最高(41.98%),高危者占21.9%。最常见并发症为产后出血(43.89%),其次为宫缩乏力(17.28%)、前置胎盘(16.59%)、子痫/子痫前期(14.67%)和胎盘植入(13.99%)。血液系统疾病为最常见合并症(57.75%),内分泌系统疾病次之(24.42%)。单因素分析显示,产后出血的发生与高龄、产检次数不足5次、经产妇身份存在统计学关联(均P<0.05);前置胎盘的发生与高龄、低学历、非汉族、初检高危评级、产检不足5次、经产存在统计学关联(均P<0.05)。结论 深圳市福田区危重症孕产妇发生率约为6.75‰,产后出血和前置胎盘为主要并发症。单因素分析显示,高龄、产检不足、初检高危分级及经产与上述主要并发症的发生相关。应加强动态妊娠风险管理和多学科协作,完善产科早期预警体系,以降低危重症孕产妇发生率,提高母婴安全水平。
Abstract: Objective To analyze the epidemiological characteristics, etiology composition, and related factors of critically ill pregnant women in Futian District, Shenzhen, from 2022 to 2024. Methods Based on the surveillance network, a retrospective descriptive analysis was conducted on 107,921 pregnant women. Chi-square tests were used to analyze the association between different factors and major complications. Results A total of 729 critically ill pregnant women were identified (overall incidence 6.75‰).??The most common complication was postpartum hemorrhage (43.89%), followed by uterine atony (17.28%), placenta previa (16.59%), eclampsia/preeclampsia (14.67%), and placenta accreta (13.99%). Univariate analysis showed that postpartum hemorrhage was statistically associated with advanced age, <5 antenatal visits, and multiparity (all P<0.05). Placenta previa was statistically associated with advanced age, low education level, non-Han ethnicity, high-risk initial assessment, <5 antenatal visits, and multiparity (all P<0.05). Conclusion The incidence of critically ill pregnant women in Futian District is approximately 6.75‰. Univariate analysis suggested that advanced age, insufficient antenatal visits, high-risk classification, and multiparity were associated with the main complications. Dynamic risk management and multidisciplinary collaboration should be strengthened.

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论著

2022—2024 年江西省南昌市东湖区孕妇碘营养状况与食用碘盐监测分析

Survey on the iodine nutrition status and iodined salt monitoring of pregnant women in Donghu District, Nanchang City,Jiangxi Province from 2022 to 2024

:1569-1573
 
       目的   调查江西省南昌市东湖区孕妇2022—2024年碘营养状况与盐碘监测情况,为区域干预提供依据。方法   将江西省南昌市东湖区划分为东、南、西、北、中5个片区,每个片区随机抽取一个街道(管理处),于每年5月份随机抽取各街道(管理处)20名孕妇,每年共抽取100名孕妇,3年共计300名孕妇,采集其尿液样本和家中食用盐样本检测碘含量,以统计学方法进行分析。结果  3年来孕妇家庭食用盐碘含量中位数为23.02 mg/kg,碘盐覆盖率为98.67%,碘盐合格率为95.33%,3年的食用盐碘含量比较差异有统计学意义(H=38.545,P<0.05)。孕妇的尿碘水平中位数为115.15 μg/mL,3年来孕妇的尿碘水平中位数均低于150 μg/mL,有62.67%的孕妇碘缺乏,3年间的尿碘水平比较差异有统计学意义(H=9.392,P<0.05),其中2024年的尿碘水平中位数为140.00 μg/mL,校正后高于2022年(Z=2.693,P<0.0167)和2023年(Z=2.590,P<0.0167)。Spearman相关性分析结果显示孕妇尿碘水平与盐碘含量及碘盐质量均无相关性(均P0.05),孕妇碘营养状况与盐碘含量及碘盐质量均无相关性(均P>0.05),孕妇尿碘水平与碘营养状况正相关(rs=0.857,P<0.05),盐碘含量与碘盐质量正相关(rs=0.314,P<0.05)。结论   江西省南昌市东湖区2024年孕妇碘缺乏有所改善,但整体形势严峻,超半数的孕妇碘缺乏,食用碘盐基本符合国家消除碘缺乏病标准,但仍需改进。卫生部门要强化孕妇碘营养监测,向孕妇科普碘缺乏病知识,增强补碘意识,促其科学补碘。盐业监管部门需加大监管,严控碘盐质量,确保东湖区居民食盐合格。
       Objective  To investigate the iodine nutrition status of pregnant women and iodined salt monitoring in Donghu District,Nanchang City,Jiangxi Province from 2022 to 2024,and provide a basis for regional intervention.Methods  Donghu District was divided into five areas:East,South,West,North,and Central.A street(management office)was randomly selected from each area,and 20 pregnant women were randomly selected from each street(management office)in May each year.A total of 100 pregnant women were selected each year,for a total of 300 pregnant women over three years.Urine samples and household salt samples were collected to detect iodine content,and statistical analysis was conducted.Results  Over the past three years,the median iodine content in the cooking salt consumed by pregnant women’s families was 23.02 mg/kg,the iodized salt coverage rate was 98.67%,and the iodized salt qualification rate was 95.33%.There were differences in the iodine content of cooking salt in the three years(H=38.545,P<0.05).The median urinary iodine level of pregnant women was 115.15 μg/mL.In the past three years,the median urinary iodine levels of pregnant women were all lower than 150 μg/ml,and 62.67% of pregnant women were iodine-deficient.There were differences in the urinary iodine levels in the three years(H=9.392,P<0.05).Among them,the median urinary iodine level in 2024 was 140.00 μg/mL,which was significantly higher than that in 2022(Z=2.693,P<0.0167)and 2023Z=2.590,P<0.0167)after correcting the significance level.Spearman correlation analysis  results showed that there was no correlation between the urinary iodine level of pregnant women with the iodine content and quality of iodized salt(all P>0.05),and there was no correlation between the iodine nutritional status of pregnant women with the iodine content and quality of iodized salt(all P>0.05).The urinary iodine level in pregnant women is positively correlated with their iodine nutritional status(rs=0.857,P<0.05),and the iodine content in salt is positively correlated with the quality of iodized salt(rs=0.314,P<0.05).Conclusions  In 2024,the iodine deficiency among pregnant women in Donghu District,Nanchang City,Jiangxi Province was improved,but the overall situation is still severe.More than half of pregnant women were iodine-deficient.The consumption of iodized salt basically met the national standards for eliminating iodine deficiency disorders,but still needed to be improved.The health department should strengthen the monitoring of iodine nutrition among pregnant women,popularize knowledge about iodine deficiency disorders to pregnant women,enhance their awareness of iodine supplementation,and promote their scientific iodine supplementation.The salt industry supervision department needs to strengthen supervision,strictly control the quality of iodized salt,and ensure that the cooking salt of residents in Donghu District is qualified.
论著

2022—2024年南宁市食源性疾病流行病学分析及卫生管理建议

Epidemiological analysis of foodborne diseases in Nanning City from 2022 to 2024

:935-944
 
目的 调查南宁市2022—2024年食源性疾病的发生情况,并分析该地食源性疾病的流行病学特征,为防控食源性疾病提供依据。方法 在2022年1月—2024年12月统计南宁市多中心上报的食源性疾病发生情况,并分析食源性疾病的分布特征。结果 2022年1月—2024年12月在南宁市共计调查21 712例食源性疾病患者,其中男性占49.25%,女性占50.75%;食源性疾病以18~59岁、4~17岁年龄段占比相对较高,在季节方面2022年以秋季占比较高,2023—2024年以夏季占比较高;散居儿童、学生和农民是食源性疾病的主要人群,混合食品、水果及其制品、粮食类及其制品、肉类及其制品为前四位暴露食品;包装方面以散装占比最高、进食场所则以家庭占比最高;食源性疾病患者3年间不同性别、年龄段、发病季节、人群类型、暴露食品、包装形式及进食场所比较差异均有统计学意义(P<0.05)。症状主要以消化道症状、其他/全身症状为主。结论 南宁市2022—2024年食源性疾病发生例数有所增长,多发于夏秋季节,散居儿童、学生、农民是食源性疾病的高风险群体,同时针对散装食品,尤其混合食品、水果及其制品、粮食类及其制品、肉类及其制品等主要暴露食品应做好重点防控监测,可根据本地食源性疾病发生的流行病学特征进行对应的宣传教育,以确保食品安全。
Objective To explore the occurrence of foodborne diseases in Nanning City from 2022 to 2024,and analyze the epidemiological characteristics of foodborne diseases in the area,providing a basis for the prevention and control of foodborne diseases.Methods From January 2022 to December 2024,the incidence of foodborne diseases reported by multiple centers in Nanning City was statistically analyzed,and the distribution characteristics of foodborne diseases were analyzed.Results From January 2022 to December 2024,a total of 21 712 foodborne disease patients were analyzed in Nanning City,among them,males account for 49.25% and females account for 50.75%.Foodborne diseases had a relatively high proportion in the age groups of 18-59 and 4-17 years old.In terms of seasons,the proportion was higher in autumn 2022 and in summer 2023-2024.Scattered children,students,and farmers were the main populations of foodborne diseases,with mixed foods,fruits and their products,grains and their products,and meat and its products being the top four exposed foods.In terms of packaging,bulk packaging had the highest proportion,while in terms of eating places,household packaging has the highest proportion.There were statistically significant differences in the gender,age group,onset season,population type,exposed food,packaging form,and eating location of foodborne disease patients over a three-year period.Conclusions The number of foodborne diseases in Nanning City has increased from 2022 to 2024,mostly occurring in summer and autumn seasons.Scattered children,students,and farmers are high-risk groups for foodborne diseases.At the same time,key prevention and control monitoring should be carried out for bulk foods,especially mixed foods,fruits and their products,grains and their products,meat and their products,and corresponding publicity and education can be carried out according to the epidemiological characteristics of local foodborne diseases to ensure food safety.
论著

2021—2022年洛阳市涧西区作业场所职业病危害因素的监测结果及具体防控策略研究

Monitoring results and specific prevention and control strategies for occupational disease hazards in workplaces in Jianxi District,Luoyang City from 2021 to 2022

:35-40
 
目的 统计洛阳市涧西区各作业场的职业病危害因素,分析职业病发生的主要原因,并探讨具体防控策略。方法 收集洛阳市涧西区内2021年1月—2022年12月期间针对各作业场的职业病危害因素监测信息,录入Excel 2010进行数据统计;随机抽取辖区内200名重点职业从业人员,开展回顾性分析,结合职业健康检查结果,将确认存在职业病的115名从业人员列为病例组,其余未发生职业病的85名从业人员列为对照组,比较2组一般资料、临床资料,经统计学单因素、Logistic多因素回归分析归纳可导致职业病发生的影响因素,结合分析结果,探讨具体防控措施。结果 针对辖区内15家厂矿企业,2021年共设立584个监测点,共测得68处锰及其化合物危害、48处矽尘危害、4处苯及其苯系物危害、12处噪声危害,超标率为22.60%(132/584);2022年共设立1 575个监测点,共测得158处粉尘危害、154处锰及其化合物危害、10处矽尘危害、13处噪声危害,超标率为21.27%(335/1 575);单因素分析结果显示,2组从业人员的年龄、工作年限、职业类型、体检频率、体检结果等比较差异均存在统计学意义;Logistic多因素回归分析显示,年龄≥50岁,工作年限≥10年,从事制造业、采矿业,未规律体检,血常规异常,免疫力差,X线胸片异常,双耳高频听力阈值≥40 dB均是发生职业病的重要原因(均P<0.05)。结论 洛阳市涧西区的职业危害因素以粉尘、锰及其化合物为主,高龄、工作年限长的制造业、采矿业人员发生职业病的风险相对较高,优化职业病防治措施并规范上述重点人群的职业健康体检能实现对职业病的有效防控。
Objective To analyze the occupational disease hazards in various workplaces in Jianxi District,Luoyang City,and to analyze the main causes of occupational disease occurrence,explore specific prevention and control strategies.Methods Monitoring information on occupational disease hazards in various workplaces within the jurisdiction from January 2021 to December 2022 was collected,Excel 2010 was used for data statistics.Two hundred key occupational employees within the jurisdiction were selected randomly for retrospective analysis.Based on the results of occupational health examinations,115 employees confirmed to have occupational diseases were included in the case group,while 85 employees who did not have occupational diseases were included in the control group.General and clinical data of the two groups were compared,and the influencing factors that could lead to the occurrence of occupational diseases were summarized through statistical single factor and multivariate logistic regression analysis. Combined with the analysis results,specific prevention and control measures were discussed.Results For 15 factories and mining enterprises within the jurisdiction,a total of 584 monitoring sites were established in 2021,and a total of 68 manganese and its compound hazards,48 silica dust hazards,4 benzene and its benzene series hazards,and 12 noise hazards were measured,which the exceeding rate was 22.60%(132/584).In 2022,a total of 1 575 monitoring sites were established,with a total of 158 dust hazards,154 manganese and its compounds hazards,10 silica dust hazards,and 13 noise hazards detected,which the exceeding rate was 21.27%(335/1 575).The results of statistical univariate analysis showed that there were certain differences in the age,years of work,occupational type,frequency of physical examinations,and results of physical examinations between the two groups of employees.Multivariate logistic regression analysis showed that age≥50 years old,working experience≥10 years,engaged in manufacturing and mining industries,irregular physical examinations,abnormal blood routine,immune differences,chest X-ray abnormalities,and binaural high-frequency hearing threshold≥40 dB were all important reasons for the occurrence of occupational diseases.Conclusions The occupational hazards in this jurisdiction are mainly dust,manganese,and their compounds.The risk of occupational diseases among elderly manufacturing and mining workers with long working years is relatively high.Optimizing occupational disease prevention and control measures and standardizing occupational health examinations for the above-mentioned key populations can achieve effective prevention and control of occupational diseases.
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