罗娟娟+徐佳+施建华

摘要[目的] 探索托幼機构中儿童肥胖干预的有效措施、研究建立肥胖儿体重控制的新模式、为托幼机构中儿童肥胖的干预提供科学的依据。[方法] 从田林地区13所托幼机构2516名幼儿中选出2所基础设施条件，教师人员配备和幼儿家庭经济文化水平基本相同的3～4岁的超重肥胖儿童分为干预组42人和对照组50人。对干预组的家长和幼儿采取健康教育、体育锻炼、营养膳食等综合干预措施。对照组仅仅在园所内进行必要的体育锻炼。，按照上海市0-6岁儿童体格发育五项指标评价参考值（2005年）、WHO儿童肥胖诊断标准（2006年）来评价干预效果。[结果] 经过一年半的干预，干预组BMI指数水平明显降低，有50.0% 的超重肥胖儿童恢复正常体重，家长对儿童肥胖相关知识认知有显著提高，差异均有统计学意义（P值均 < 0.05），肥胖超重比（ORR）比值达到理想水平。而对照组则未见明显改善 [结论] 社区综合干预模式，在促进儿童生长发育的同时，能有效地减缓幼儿肥胖发病率升高，是一种切实可行的控制幼儿肥胖发病的方法。

关键词：社区 综合干预模式 学龄前肥胖幼儿 有效性 中图分类号：R1 ；文献标志码：A

E ffect studies on community comprehensive intervention model for preschool obesity children

LUO Jan-juan，XU-jia，SHI Jian-hua

Shanghai Xuhui District Tianlin Street Community Health Service Center， Shanghai 200233，China

Abstract： Objective To explore effective measures for intervention of childhood obesity in childcare facilities， and to establish the new mode of FeiPanEr weight control， then providing scientific basis for childhood obesity intervention in childcare facilities. . Methods From a total of 2516 children and their attended 13 childcare facilities of Tianlin area were selected 2 facilities with basically similar infrastructure conditions， teachers staff ； and with similar family economic and cultural level， 42 overweight obese children aged 3-4 were included in intervention group and 50 in control group. Comprehensive intervention measures（health education， physical exercise and healthy diet） were taken for the parents and their children in intervention group. And for control group， only necessory physical exercise was taken in the kindergarten. According to By means of Shanghai five indicators evaluation reference （2005） for， 0 - 6 years old old children and the WHO diagnostic criteria （2006） for childhood obesity was evaluated the efficacy of the intervention. Results After one and half years of intervention， BMI levels were remarkbaly decreased in intervention group， and 50.0% of obese children recovered to normal weight. Their parents cognitive knowledge about childhood obesity increased significantly， whose difference had statistical significance （P values < 0.05）. The ratio of obesity overweight ratio（ORR） reached an ideal level. . However， the control group showed no significant improvement in this regard. Conclusion Community comprehensive intervention model， promoting the growth and development of children， can effectively reduce the incidence of obesity in young children. It is a feasible way to control the morbidity of childhood obesity.endprint

Key words： community Integrated intervention model preschoolers effect

肥胖 是一种热量代谢失衡，导致全身脂肪组织过度增生，体重超常的一种慢性疾病。肥胖，尤其是中心性肥胖（内脏性肥胖）与胰岛素抵抗、2Ⅱ糖尿病、高血压、高血脂症、冠心病等代谢综合征的发生密切相关「1」。随着我国国民经济的迅速发展，在人民生活水平不断提高的同时，儿童肥胖的问题也日渐突出。近二十年来超重肥胖检出率呈高速增长态势。2006年0～6岁儿童肥胖和超重总检出率为7.2%和19.8%，学龄前儿童超重和肥胖发生率位居各年龄段之首「2」。现有多项研究表明社区综合干预模式对学龄期儿童和成人均有较好的效果「3-4」。……