儿童预防接种不良反应发生因素及护理研究

实用临床护理学杂志Journal of Clinic Nursing's Practicality 2019年第4卷第14期

V ol.4, No.14, 20191?论 著?

儿童预防接种不良反应发生因素及护理研究

朱红飞

(青岛市北区水清沟街道社区卫生服务中心,山东 青岛 266555)

【摘要】目的?调查儿童预防接种不良反应发生的相关因素,并探讨其护理对策。方法?将2015年1月至2018年1月于我院进行预防接种的0~6岁2000名儿童作为研究对象。对所有研究对象的不良反应进行诊断,查阅文献结合本中心具体情况,调查患儿接种的疫苗种类、患儿体质、患儿心理因素如过度紧张、恐惧、接种时间、疫苗接种操作不规范、接种后患儿作息及环境情况。根据调查的儿童预防接种不良反应发生的相关因素实施针对性的接种前、接种时、接种后护理干预。结果?30名儿童发生的预防接种不良反应经给与适当处理后均痊愈。儿童预防接种不良反应发生的首位原因为接种时间的原因(夏季接种暴露注射部位,儿童自己易抓挠),其次为疫苗本质因素,另外儿童体质因素和心理因素、接种操作不规范所占比例也较高,疫苗质量引起的不良反应比例最低。发生不良反应的30名儿童,再次进行疫苗接种时,给与护理干预后,仅有2名儿童再次出现不良反应。男性儿童占56%,女性儿童占44%,不良反应发生率降低为0.1%。结论?儿童预防接种不良反应的发生涉及儿童本身、疫苗以及接种操作方面的多个因素,针对各个因素进行护理干预能够降低不良反应的发生率,临床上需给与足够重视。

【关键词】儿童;预防接种;不良反应;护理

【中图分类号】R473 【文献标识码】A 【文章编号】ISSN.2096-2479.2019.14.1.02

The study on factors of adverse reactions of child vaccination and nursing research

Zhu Hong-Fei (Department of Vaccination, Community Health Service Center, Shuiqinggou Street, North District, Qingdao, Shandong 266555)

【abstract 】 Objective To Investigate the related factors of children's vaccination adverse reactions and explore the nursing strategies. Methods 2000 children aged 0 to 6 who were vaccinated in our hospital from January 2015 to January 2018 were included in the study. The adverse reactions in all subjects were diagnosed.Review the literature and the specific conditions of the center, the types of vaccines vaccinated, the physical condition of children, psychological factors such as excessive stress, fear, vaccination time, irregular vaccination operation, children's work and vaccination after vaccination and environmental conditions were investigated.Targeted pre-vaccination, vaccination, and post-vaccination care interventions were performed based on factors related to the occurrence of adverse reactions to child vaccination. Results The adverse reactions to vaccination in 30 children were cured after appropriate treatment. The first cause of adverse reactions to child vaccination is that he duration of inoculation (exposure to the injection site during summer vaccination is easy for children to scratch themselves), followed by the essential factor of vaccine, and the children's physical and psychological factors, the proportion of vaccination operations are also high. The proportion of adverse reactions caused by the vaccine quality is the lowest.In the 30 children who developed adverse reactions, only two children developed adverse reactions after the vaccination received nursing intervention. Male children accounted for 56 percent and female children 44 percent,and the incidence of adverse reactions decreased to 0.1%. Conclusion The occurrence of adverse reactions in children's vaccination involves many factors in children, vaccines and vaccination operations. Nursing interventions for various factors can reduce the incidence of adverse reactions and require sufficient attention in clinical practice.

【Key words 】 children; vaccination; adverse reactions; nursing

我国实行对儿童的预防接种制度,应用疫苗接种于机体,使

儿童产生对传染病获得特异性免疫,花费低、效果显著,对保障

儿童免受传染病侵袭的有效方法[1]。目前使用的疫苗是安全有效

的,但因多种因素的影响,使进行预防接种的儿童出现了一些不

良反应,对儿童产生一定的危害,甚至因此引起医疗纠纷。对儿

童预防接种产生的不良反应的原因进行调查,并给与针对性的护

理干预,能够降低不良反应的发生率,改善医患关系。1?临床资料和方法1.1 临床资料 将2015年1月至2018年1月于我院进行预防接种的2000名儿童作为研究对象。其中,男1021例,女979例,年龄0~6岁,平均(4.21±1.49)岁;所有儿童接种疫苗为国家计划免疫免费疫

苗,包括:乙肝、百白破、脊髓灰质炎、麻风腮、卡介苗、流脑、乙脑、甲肝、水痘等。1.2 入选与排除标准 入选标准:按计划接种疫苗的儿童.1.3 诊断标准 依据《免疫预防与疾病控制》标准[2]对所有研究对象的不良反应进行诊断。将儿童预防接种产生的不良反应分为:一般反

应、偶合反应、异常反应。一般反应:因疫苗本身特异性引起,

包括全身性反应和局部性反应,为一过性不良反应。患儿临床表

现多种多样,包括发热、注射部位红肿等。偶合反应:患儿可能

在接种疫苗前已存在不明显的症状,接种后出现症状,其发生率

不高。异常反应:发生率较低的一类不良反应,患儿多表现为过

敏性皮疹、过敏性休克等。(下转7页)

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