本文選題：妊娠期 + 缺鐵性貧血��； 參考：《天津醫(yī)科大學》2016年碩士論文

【摘要】：目的:(1)通過對患有妊娠期缺鐵性貧血的孕婦和正常孕婦的孕期膳食攝入進行調(diào)查比較,探討妊娠期膳食對妊娠期缺鐵性貧血的影響。(2)通過研究個體化營養(yǎng)干預方案的實施效果,探索有效的治療孕婦缺鐵性貧血的營養(yǎng)干預模式。方法:(1)采用回顧性病例對照研究方法,對105例妊娠期缺鐵性貧血孕婦(病例組)和同期同所醫(yī)院正常妊娠的105例正常孕婦(對照組)進行孕期膳食攝入頻率問卷調(diào)查,調(diào)查內(nèi)容為孕婦妊娠期間攝入膳食的頻率和攝入量。問卷分為常規(guī)膳食和特殊膳食兩部分。通過比較兩組孕婦妊娠期食物攝入的頻率,采用單因素分析和多因素logistic回歸分析,篩選出與妊娠期缺鐵性貧血發(fā)生相關的膳食因素。(2)采用隨機對照試驗方法,將患有妊娠期鐵缺乏的孕婦隨機分為干預組(35例)采用孕婦個體化營養(yǎng)干預方案,對照組(35例)采用常規(guī)健康教育方法。個體化營養(yǎng)干預方案包括營養(yǎng)檔案的建立、膳食調(diào)查與監(jiān)測和開具營養(yǎng)處方等。效果評估指標時間分別為孕12周、孕20周、孕28周和孕36周,評估指標為分別比較兩組孕婦日均鐵攝入量、血紅蛋白和血清鐵蛋白、平均紅細胞體積、妊娠結(jié)局和分娩結(jié)局指標。結(jié)果:(1)在妊娠期膳食攝入頻率方面,病例組和對照組孕婦孕期攝入水果類、谷薯類、油脂類和蔬菜類的頻率差異沒有統(tǒng)計學意義(P0.05);病例組孕期血制品、動物內(nèi)臟、肉禽魚類、鈣、鐵、維生素補充劑的攝入頻率與對照組相比,低于對照組孕婦。病例組攝入刺激性飲品、干果類、豆類、奶類及奶制品的頻率與對照組相比,高于對照組孕婦,差異有統(tǒng)計學意義(P0.05)。單因素logistic回歸分析初步篩選出8項相關因素。進一步進行多因素條件logistic回歸分析結(jié)果顯示,妊娠期經(jīng)常攝入血制品、肉禽魚類、動物內(nèi)臟、鈣補充劑、維生素補充劑、鐵補充劑可能為妊娠期缺鐵性貧血的保護性因素;而妊娠期缺鐵性貧血的危險因素可能為經(jīng)常攝入刺激性飲品、奶類及奶制品。(2)干預后對兩組孕婦的相關指標進行比較,結(jié)果顯示干預組的鐵攝入量、血紅蛋白、平均紅細胞體積和血清鐵蛋白指標均優(yōu)于對照組,二者差異有統(tǒng)計學意義(P0.05)。對照組與干預組相比,干預結(jié)束后比較兩組孕婦妊娠期鐵缺乏患病率,差異具有統(tǒng)計學意義(P0.05)。兩組孕婦妊娠結(jié)局比較,結(jié)果顯示兩組妊娠期鐵缺乏孕婦分娩后分析孕期體重增重方面,干預組相比對照組更優(yōu),差異有統(tǒng)計學意義(P0.05)。對兩組孕婦其他妊娠期并發(fā)癥和分娩并發(fā)癥的發(fā)生率進行比較,干預組與對照組相比,妊娠期糖尿病的發(fā)病率較低,差異有統(tǒng)計學意義(P0.05)。兩組孕婦在其他妊娠期合并癥和不良妊娠結(jié)局方面比較,差異無統(tǒng)計學意義(P0.05)。結(jié)論:(1)妊娠期增加肉禽魚類、血制品、動物內(nèi)臟、鈣、鐵、維生素補充劑的攝入可以有效預防或減少妊娠期缺鐵性貧血的發(fā)生。而孕期刺激性飲品、牛奶及奶制品的攝入頻次過多可能會增加妊娠期缺鐵性貧血發(fā)生的風險。(2)孕婦個體化營養(yǎng)干預方案對治療妊娠期婦女鐵缺乏有較好的干預效果,在改善妊娠結(jié)局方面,妊娠期個體化營養(yǎng)干預方案對孕期合理增重有較好影響,在預防其他妊娠期并發(fā)癥方面無顯著效果。
[Abstract]:Objective: (1) to explore the effect of pregnancy diet on iron deficiency anemia during pregnancy by comparing the dietary intake of pregnant women with pregnant women with iron deficiency anemia and normal pregnant women. (2) through the study of the implementation effect of individualized nutrition intervention program, the effective treatment mode for the treatment of iron deficiency anemia in pregnant women was explored. (1) a retrospective case control study was used to investigate the frequency and intake of dietary intake of 105 pregnant women with iron deficiency anemia (case group) and 105 normal pregnant women (control group) during the same period of normal pregnancy (control group). The questionnaire was divided into regular diet and special diet. The two part of the special diet. By comparing the frequency of the food intake in the two groups of pregnant women, using single factor analysis and multiple factor Logistic regression analysis, the dietary factors related to the occurrence of iron deficiency anemia in pregnancy were selected. (2) a randomized controlled trial was used to randomly divide pregnant women with iron deficiency into the intervention group (35 cases) to adopt pregnancy. In the control group, the control group (35 cases) adopted the routine health education method. The individualized nutrition intervention program included the establishment of nutritional archives, the dietary survey and monitoring and the prescriptions of nutrition. The evaluation indexes were 12 weeks of pregnancy, 20 weeks of pregnancy, 28 weeks of pregnancy and 36 weeks of pregnancy. The evaluation indexes were compared to the average daily iron rate in the two groups of pregnant women. Intake, hemoglobin and serum ferritin, mean red cell volume, pregnancy outcome and delivery outcome indicators. Results: (1) there was no statistical difference in the frequency of intake of fruits, Cereals, Oils and vegetables during pregnancy in pregnant women and control groups (P0.05). The frequency of intake of viscera, fowl fish, calcium, iron, vitamin supplement was lower than that of the control group. The frequency of intake of stimulant drinks, dried fruit, legumes, milk and dairy products in the case group was higher than that of the control group, the difference was statistically significant (P0.05). The single factor Logistic regression analysis was a preliminary screening of 8 items. Related factors. Further multivariate conditional logistic regression analysis showed that frequent intake of blood products during pregnancy, meat fowl fish, animal viscera, calcium supplements, vitamin supplements, and iron supplements may be protective factors for iron deficiency anemia in pregnancy, and the risk factors for iron deficiency anemia in pregnancy may be regular intake of stimulation. Sexual drinks, milk and dairy products. (2) compared to the related indexes of two groups of pregnant women after the intervention, the results showed that the iron intake, hemoglobin, mean red blood cell volume and serum ferritin were superior to the control group in the intervention group, and the difference between the two groups was statistically significant (P0.05). Compared with the intervention group, the control group compared the two groups of pregnant women after the intervention. The incidence of iron deficiency during pregnancy was statistically significant (P0.05). The results of pregnancy outcome in two groups of pregnant women showed that the two groups of pregnant women with iron deficiency were better than the control group after childbirth analysis. The difference was statistically significant (P0.05). Other pregnancy complications and childbirth complications in the two groups of pregnant women were found. Compared with the control group, the incidence of gestational diabetes was lower than the control group, the difference was statistically significant (P0.05). There was no significant difference between the two groups of pregnant women in other pregnancy complications and bad pregnancy outcomes (P0.05). Conclusion: (1) the increase of meat fishes, blood products, animal viscera, calcium, iron, and vitamin D during pregnancy. The intake of vegetative supplements can effectively prevent or reduce the incidence of iron deficiency anemia during pregnancy. The risk of iron deficiency anemia in pregnancy may be increased by excessive intake of milk and milk and milk products during pregnancy. (2) the individualized nutrition intervention program of pregnant women has a better effect on the treatment of iron deficiency in pregnant women. In terms of improving pregnancy outcome, the individualized nutrition intervention program during pregnancy has a good effect on reasonable weight gain during pregnancy, and there is no significant effect in preventing complications of other pregnancy.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R714.254

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