【摘要】 目的了解儿科医师对维生素A缺乏的认知及维生素A补充剂的应用现状,并分析影响因素。方法采用自制问卷,在"儿童保健微信群"内对儿科医师(儿科专科医师和儿童保健医师)进行问卷调查。采用单因素和多因素无序多分类Logistic回归分析维生素A补充剂应用的影响因素。结果共1 900名儿科医师完成了问卷调查。72.9%的儿科医师会在临床工作中推荐家长使用维生素A补充剂。接受过维生素A相关培训的儿科医师更倾向于推荐家长应用维生素A补充剂,其中1年内接受培训的OR(95%CI)为6.434(1.954～21.178),1～3年内接受培训的OR(95%CI)为9.287(2.207～39.080);相较于三级甲等医院,二级医院的儿科医师根据情况推荐家长使用维生素A补充剂的比例更低,OR(95%CI)为0.437(0.222～0.862)。了解至少1种维生素A的来源、维生素A缺乏的高危因素及相关疾病的儿科医师占比99.0%以上。了解维生素A缺乏和边缘型维生素A缺乏诊断标准的儿科医师占比约50.0%。儿科医师中,认为儿童需要规律补充维生素A的占比为85.2%,但是在补充开始时间、结束时间和剂量方面的认识参差不齐。结论大部分儿科医师对于维生素A相关知识的了解程度较高。维生素A补充剂的整体应用率较高,但由于无统一规范的应用指南,维生素A的补充仍有诸多不合理之处,需进一步针对儿科医师开展相关知识的培训。更多还原

【Abstract】 Objective To understand the status of pediatricians’ understanding of vitamin A deficiency and the application status of vitamin A supplements, and analyze the influencing factors. Methods A self-made questionnaire was used to survey on pediatricians(pediatric specialists and child health care doctors) in the “children health care WeChat group”. Univariate and multivariate disordered multi-classification Logistic regression analyses were used to analyze the influencing factors of vitamin A supplement application. Results A total of 1 900 pediatricians completed the questionnaire survey. Among them, 72.9% would recommend parents to use vitamin A supplementation in clinical practice. Pediatricians who had received vitamin A-related training were more likely to recommend parents to use vitamin A supplements. Among them, the OR values(95%CI) of training within 1 year and within 1-3 years were 6.434(1.954-21.178) and 9.287(2.207-39.080). In addition, compared with tertiary hospitals, pediatricians in secondary hospitals would recommend parents to use vitamin A supplements according to the situation in a lower proportion, with an OR value(95%CI) of 0.437(0.222-0.862). More than 99.0% of pediatricians knew at least one kind of vitamin A source, high risk factors of deficiency and related diseases. About 50.0% of pediatricians knew the diagnostic criteria of vitamin A deficiency and marginal vitamin A deficiency. And 85.2% of pediatricians believed that continuous supplementation of vitamin A was needed, but they had different understanding of the start time, end time, and dosage. Conclusion Most pediatricians know a lot about vitamin A. The application rate of vitamin A supplements is high. However, there are still many unreasonable aspects of vitamin A supplementation due to the lack of uniform guidelines. The related training and education should be carried out for pediatricians.更多还原