【摘要】 目的调查脑性瘫痪(脑瘫)患儿免疫规划疫苗接种的现状。方法选取2007年10月—2009年6月在我院儿童康复中心接受治疗的脑瘫患儿285例为研究对象,其中,本地患儿98例,外地患儿187例;根据诊断脑瘫时的年龄分为0～个月组68例,3～个月组71例,6～个月组73例,9～12个月组73例。调查患儿12月龄内完成卡介苗(BCG)、脊髓灰质炎减毒疫苗(OPV)、百白破联合疫苗(DPT)、麻疹疫苗(MV)及乙型肝炎疫苗(HepB)的接种情况;患儿家长对预防接种的必要性及不良反应的认识;接种后不良反应发生情况。结果 285例脑瘫患儿的建卡率为98.6%(281/285),卡疤率为95.1%(271/285);BCG、OPV、DPT、MV接种率分别为98.6%(281/285)、60.0%(171/285)、61.4%(175/285)、59.3%(169/285);四苗全程接种率54.7%(156/285),HepB首针及时接种率96.8%(276/285),HepB全程接种率60.0%(171/285)。本地患儿组和外地患儿组BCG、OPV、DPT、MV、四苗全程及HepB全程接种率比较,差异均有统计学意义(P<0.05)。不同诊断年龄组患儿OPV、DPT、MV、四苗全程及HepB全程接种率比较,差异均有统计学意义(P<0.05)。患儿家长对预防接种的必要性及不良反应认识情况好51例(占17%),认识情况一般96例(占33.7%),认识情况不好138例(占48.4%)。仅1例出现轻度发热,因OPV疫苗引起,合并癫痫的45例脑瘫儿的癫痫发作与预防接种无直接关系。结论脑瘫患儿尤其是外地的,计划免疫完成率低,流动性、部分医务人员及家长对脑瘫接种后不良反应不恰当的评估是影响接种率的主要因素,应建立法规性文件防止因各种非正常因素导致的脑瘫患儿接种率的下降。更多还原

【Abstract】 Objective To investigate the vaccination status of children with cerebral palsy.Methods 285 children(98 cases of local children and 187 cases of nonlocal children) with cerebral palsy children admitted to our hospital from October 2007 to June 2009 were involved into the study.According to the age on diagnosis,all the children were divided into 0~ months group(68 cases),3~ months group(71 cases),6~ months group(73 cases) and 9~12 months group(73 cases).The status of the vaccination of BCG,OPV,DPT,MV and HepB,the recognition of vaccination and adverse events of vaccination by parents and the adverse event occurred were investigated.Results The rate for vaccination certificates establishment was 98.6(281/285),the scar rate was 95.1%(271/285),the vaccination rates of BCG,OPV,DPT and MV were 98.6%(281/285),60.0%(171/285),61.4%(175/285) and 59.3%(169/285),the complete vaccination rate of the four was 54.7%(156/285),the prompt first vaccination rate of HepB was 96.8%(276/285),and the complete vaccination rate of the HepB was 60.0%(171/285).The complete vaccination rates of the BCG,OPV,DPT,MV and HepB between local children and nonlocal children and between difference age groups all showed statistically significant differences(P<0.05).51 parents(17.9%) had good recognition of vaccination,96 parents(33.7%) had ordinary recognition and 138 parents(48.4%) had bad recognition.One case had slight fever due to OPV vaccination.The epilepsy occurred in 45 cerebral palsy children was not directly related to vaccination.Conclusion The coverage rates of vaccination in cerebral palsy children especial nonlocal cerebral palsy children are low.The main reasons are mobility and improper assessment of adverse events following immunization(AEFI).Legal documents should be established to prevent various non-normal factors leading to the decrease in vaccination rates for cerebral palsy children.更多还原