湘雅儿科精品课件-HealthCareofChil

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,每个儿童都应该有一个尽可能好的人生开端,;,每个儿童都应该接受良好的基础教育,;,每个儿童都应该有机会充分发掘自身潜能成长为一名有益于社会的人,.,-,安南,2001,年,9,月联合国大会儿童特别会议前夕,儿 童 保 健,Health Care of Children,中南大学,儿科学教研室,第三章,目的要求,熟悉儿童各,年龄,期保健原则,了解儿童保健的具体措施,掌握儿童的预防接种,Purpose and requirement,To master the principles of health care in the period of children.,To get the measure of health care of children,To master the vaccination of children.,儿童保健的概念,(idea of child care),儿童保健的内容,(content of child care),儿童保健的目的,(intent of child care),儿童保健的状况,(status of child care),概述,儿童保健的概念,idea of child care,它是研究从胎儿到青少年期的生长发育、营养保障、疾病防治、健康管理和生命统计等的一门综合性学科。,儿童保健的内容,:,content of child care,1.,生长发育,2.,体质健康与健康促进,3.,喂养 营养,4.,危及生长发育和健康的危险因素识别与干预,5.,个体与人群疾病控制,6.,意外伤害防治,7.,人与环境和谐,儿童保健的目的,intent of child care,防治小儿常见病、多发病、减少发病率。,降低小儿死亡率。,促进小儿身心健康成长。,概述,新生儿,：,每天有大于,3.5,万人,neonate,：,35 thousands dead every day,5,岁以下儿童,：,每年近,1300,万,children under five almost 13 millions dead,years old,：,every year,世界儿童死亡状况,The child mortality in the world,tal,我国儿童保健状况,The status of children in China,中国婴儿及,5,岁以下儿童死亡率,The neonatal and children under five years old mortality in China,1960,年（,）,1991,年（,）,1995,年（,）,1997,年（,) 2000,年（,）,婴儿,140 50.2 36.4 33.1 33.5,neonatal,5,岁以下儿童,209 61 44.5 42.3 40.6,Under Five years old,我国儿童保健工作取得进展的原因,:,儿童保健机构的建立和健全,儿童保健队伍的发展,制定系列法律、法规,计划免疫普遍推广,孕母保健,(health care of pregnant woman),婚前检查，遗传学咨询,Prevention of congenital abnormality and,hereditary disease,防治疾病，慎用药物,prevention and cure,illness,to,use,druggery,careful,避免接触放射线及毒物,avoid contacting with radiation and poison,充足营养，良好的生活环境,Sufficient nutrition, supplement iron,高危产妇定期产前检查，必要时终止妊娠,High risk pregnant woman must check-up,胎儿期,Fetal period,各年龄期儿童保健,原则,及,重点,各年龄期儿童保健,原则,及,重点,胎,儿,期,Fetal,period,胎儿保健,(health care of fetus,),预防产时感染和疾病,Prevent from infection in parturition,Prevent from hypoxia, asphyxia and lower,body temperature of,perinatal,stage,胎教,Pre-natal education,各年龄期儿童保健,原则,及,重点,生后,一周,为保健重点,出生时护理,tend and protect at the born,新生儿居家保健,health care of neonatal period in,the family,新生儿期,Neonatal,period,发病率,死亡率,高！,各年龄期儿童保健,原则,及,重点,婴儿期,infantile age,合理喂养提倡母乳,advocate to breast feeding,add supplementary food on,time,.,生长发育监测,re,gular physical,check-ups,坚持户外活动,take part in out-door,exercises,完成基础免疫,received the basal,immunization.,各年龄期儿童保健,原则,及,重点,幼儿期,infancy,良好的习惯,good habits,预防疾病及事故,p,revention from diseases,and accidents,各年龄期儿童保健,原则,及,重点,学龄前期,pre-school age,早期教育,earlier period education,培养良好的习惯,good habits,加强锻炼,physical training,疾病意外事故防治,illness and accidents prevention,各年龄期儿童保健,原则,及,重点,学龄期及青春期,school age and puberty,保证营养，培养习惯,sufficient nutrition, good habits,加强锻炼，健全体格,physical training,预防近视、龋齿、贫血,prevention from myopia, tooth caries, anemia,重视生理心理卫生教育,thinking highly of physiological and,psychologic,education,儿童的心理卫生,mental health,心理卫生即人们的生活环境与内心之间保持和谐平衡,.,现在儿童的身体发育处于加速时期,心理发育相对滞后,.,中南大学精卫所对湖南,2522,名,13-16,岁青少年进行流行病学调查发现精神障碍的患病率为,8.72,%.,儿童保健的具体,措施,护理,(care),营养,(nutrition),计划免疫,(program immunization),儿童心理卫生,(mental health of child),定期健康检查,(regular physical check-ups),体格锻炼,(physical exercise),意外事故预防,(accidents prevention),是根据小儿的免疫特点和传染病发生的情况制定的免疫程序，有计划的使用生物制品进行预防接种，以提高人群的免疫水平、达到控制和消灭传染病的目的。,计 划 免 疫,(Program immunization),Program immunization,The planned immunization is enacted according to immunology principle, immunity characteristics of children and epidemic situation of infectious disease. We make use of biological products as vaccine in order to raise the immunity level of the crowd, control and eradicate infectious diseases,.,预防接种,-,儿童保健的重要内容,出生婴儿从母体里获得一定的抵抗传染病的能力,一般不易患传染病,随着婴儿生长,这种抵抗力逐渐减弱或消失,孩子就容易患各种传染病,为提高儿童抵抗传染病的能力,预防多种传染病,就需要有计划的给孩子进行预防接种,以保护儿童身体健康,.,卡介苗（减毒活结核菌）,预防的疾病：,结核病,接种方法：,皮内注射,接种部位：,左上臂三角肌上端,初种年龄：,生后,2-3,天到,2,月内,反应：,局部小溃疡 全身播散性卡介苗症,注意：,2,月小儿，,PPD(-),后接种 卡疤,体重,2kg,的早产儿不能接种,BCG vaccine (attenuated vital vaccine),Prevented disease:,tuberculosis,Vaccination method:,intradermic,injection,Location:,the left upper arm deltoid,Age of primary vaccination:,2-3 days to 2-month-old,Adverse effects:,local ulceration,disseminated BCG infection,Notice:,PPD test is necessary before vaccination,if the child is more than 2-month-old.,vaccination while weight more than 2 kg,1995,年世界卫生组织决定停止复种我国卫生部,1997,年决定停止复种,卡介苗的接种并不能控制结核病的流行,卡介苗复种的效果未被完全证实,以结核菌素试验阴性来决定卡介苗复种的对象缺乏科学的依据,卡介苗复种时的副反应较初种时明显增加,基因重组乙肝疫苗,预防的疾病：,乙型肝炎,接种方法：,肌肉注射,接种部位：,上臂三角肌,初种年龄：,0,月、,1,月、,6,月,复种：,3-5,年,反应：,局部红肿,viral hepatitis type B gene vaccine,Prevented disease:,HBV,Vaccination method:,intramuscular injection,Location:,the upper arm deltoid,Age of primary vaccination:,at the 1st day,1st,month ,6th month,Repeat vaccination:,35 years old,Adverse effects:,local reactions,携带,HBV,母亲所生婴儿的乙型肝炎疫苗接种,:,采用联合免疫,即出生,12h,内注射乙型肝炎免疫球蛋白,同时注射乙型肝炎疫苗,.,早产儿的乙型肝炎疫苗接种,:,出生体重低于,2kg,早产儿,美国推荐推迟首剂接种至体重达,2kg,或,2,月龄时,.,我国属乙肝高发区,因此要求出生时即接种乙型肝炎疫苗,但在完成全程免疫后,应检测抗体水平,对无反应或低反应者及时加强免疫,.,脊髓灰质炎,减毒活疫苗,预防的疾病：,脊髓灰质炎,接种方法：,口服,初种年龄：,2,月、,3,月、,4,月,复种：,4,岁,反应：,低热、轻泻,注意,:,冷开水送服,服后,2,小时禁服开水,poliomyelitis attenuated live vaccine,Prevented disease:,poliomyelitis,Vaccination method:,oral,Age of primary vaccination:,the 2nd,3rd,4th month,Repeat vaccination:,at age 4 years,Adverse effects:,mild fever and diarrhea,Notice:,using cold water to ingest the tab,Hot water is contraindicated within 2hr after,swallowing the tab.,脊髓灰质炎强化免疫,实施范围,:,主要在常规免疫工作薄弱地区和流动人口等特殊人群中开展,.,强化免疫时间,:,每年,1,月,5,日,6,日,12,月,5,日,6,日,.,强化免疫对象,:,不同年龄阶段,的儿童,强化免疫目的,:,彻底消灭脊髓灰质炎,.,百日咳 菌液、白喉 破伤风类毒素,预防的疾病：,百日咳、白喉、破伤风,接种方法：,皮下注射,接种部位：,上臂外侧,初种年龄：,3,月、,4,月、,5,月,复种：,1.5-2,岁,7,岁,白破二联类毒素,反应：,低热、局部红肿,pertussis,bacterin,diphtheria,toxoid,tetanus,toxoid,Prevented disease:,pertussis,、,diphtheria and,tetanus,Vaccination method:,subcutaneous injection,Location:,the external side of upper arm,Age of primary vaccination:,the 3rd,4th,5th month,Repeat vaccination:,1.52 years,7 years old,children, DT,Adverse effects:,local reactions, fever,麻疹减毒活疫苗,预防的疾病：,麻疹,接种方法：,皮下注射,接种部位：,上臂外侧,初种年龄：,8,月以上,复种：,7,岁,反应：,部分轻度发热皮疹,注意：,种,前,1,月、后,2,周不用丙种球蛋白,及胎盘球蛋白,measles attenuated live vaccine,Prevented disease:,measles,Vaccination method:,subcutaneous injection,Location:,the external side of upper arm,Age of primary vaccination:,at age 8 months or,older,Repeat vaccination:,7 years old,Adverse effects:,fever, skin eruption,Notice:,avoid using placenta or,gammaglobulin,1 month before or 2 weeks after vaccination,减少相关疾病,2.8,亿人次,减少死亡,342,万人,减少住院医疗费用,364,亿元,计划免疫,功高盖世,基础免疫：,1,岁内的免疫接种,口 诀,出生乙肝卡介苗 二月脊灰炎正好,三四五月百白破 八月麻疹岁乙脑,免疫功能低下者、免疫缺陷病者,immunodeficiency,明确过敏史,be sensitive to,hypersusceptibility,严重的心、肾脏疾病,with serious heart and kidney diseases,腹泻时禁服脊髓灰质炎疫苗,diarrhea,急性传染病,acute infectious disease,大脑发育不全禁种百白破,semideveloped,cerebra,convulsions,、,seizures,禁忌证,思考题,小儿计划免疫的初种与复种年龄有何不同,?,免疫功能低下者、免疫缺陷病患者能进行计划免疫吗,?,是否可以同时使用几种疫苗,以减少使用次数,?,Thank you !,禁禁,