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Vol. 23 No. 2 Apr. - Jun. 2006 J Prapokklao Hosp Clin Med Educat Center 75 π‘æπ∏åµâπ©∫—∫ §≈‘π‘°æàÕ·¡à§π‡°àß„π‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ ®.™≈∫ÿ√’ ®‘µ√“æ√ ∏π∫¥’ æ.∫.* πÿ™®√‘π∑√å æŸ≈ «— ¥‘Ï æ¬.∫.* ∑‘æ¬å«√√≥ ∫”√ÿß®‘µµå æ¬.∫.* Abstract Parenting Class in Health Promoting Hospital, Chonburi province Jitraporn Tanabodee M.D.* Nuchjarin Poolsawat B.Ns.* Tipwan Bumrungjit B.Ns.* * Health Promoting Hospital, Regional Health Promotion Center 3, Chonburi Province, Thailand. J Prapokklao Hosp Clin Med Educat Center 2006;23:75-81. Objective To evaluate the knowledge and attitude of pregnant women and their husbands before and after health education program regarded prenatal and perinatal care in parenting class. The satisfaction of the health education model was also evaluated. Material and Method This study was a single group pretest post-test design. Pregnant women with their husbands, got 3 times of health education regarded prenatal and perinatal care including exercise until delivery at Health Promoting Hospital from 1 June 2004 to 30 April 2005. There were three collecting data forms : The examination form for knowledge and attitude evaluation before and after health education, the satisfaction form and the questionnaire form. The data were analyzed by mean percentage, standard deviation, Paired - samples t-test. Results Fifty-seven couples of pregnant women and their husbands who enrolled the entire study got post-test knowledge and attitude scores 16.3 and 17.9 respectively, which were significant higher than pretest score (11.3 and 12.8 respectively). The satisfaction score was in high level. The low birth weight rate was 3.5 percent. The birth asphyxia rate was 35.1 per 1000 livebirths. The knowledge and attitude questions which the least people got right answer were : At the 32 weeks gestational age and more, the fetus moves at least 10 times per day. And wearing popular tight-fit clothes, has no bad effect to pregnancy. Conclusion Pregnant women and their husbands got more knowledge and positive attitude of prenatal and perinatal care from health education. The low birth weight rate was not over than 7 percent. Therefore, we should apply this program to get the best benefit. * ‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 3 ®—ßÀ«—¥™≈∫ÿ√’ 76 «“√ “√»Ÿπ¬å°“√»÷°…“·æ∑¬»“ µ√å§≈‘π‘° ‚√ßæ¬“∫“≈æ√–ª°‡°≈â“ ∫∑π” ª√–‡∑»‰∑¬¬—ߪ√– ∫ªí≠À“ “∏“√≥ ÿ¢„π¥â“π ·¡à·≈–‡¥Á°µ—Èß·µà°“√Ω“°§√√¿å®π∂÷ß°“√§≈Õ¥ ¥—ß ¢âÕ¡Ÿ≈Õπ“¡—¬·¡à·≈–‡¥Á°ª√–‡∑»‰∑¬ªïæ.». 2545 æ∫ Õ—µ√“ à«π°“√µ“¬¢Õß¡“√¥“ 22.1:100,000 °“√‡°‘¥¡’ ™’æ Õ—µ√“°“√µ“¬ª√‘°”‡π‘¥ 9.2:1000 °“√‡°‘¥∑—ÈßÀ¡¥ Õ—µ√“°“√¢“¥ÕÕ°´‘‡®π„π∑“√°·√°‡°‘¥ 32.5:1000 °“√‡°‘¥¡’™’æ Õ—µ√“∑“√°·√°‡°‘¥πÈ”Àπ—°πâÕ¬°«à“ 2,500 °√—¡ √âÕ¬≈– 8.81 ‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ ªïæ.». 2546 æ∫Õ— µ √“°“√¢“¥ÕÕ°´‘ ‡ ®π„π∑“√°·√°‡°‘ ¥ 36.5:1000 °“√‡°‘¥¡’™’æ Õ—µ√“∑“√°·√°‡°‘¥πÈ”Àπ—° πâÕ¬°«à“ 2,500 °√—¡ √âÕ¬≈– 9.8 ‰¡àæ∫°“√µ“¬ª√‘ °”‡π‘¥·≈–°“√µ“¬¢Õß¡“√¥“2 ´÷Ë߬—߉¡à∫√√≈ÿµ“¡‡ªÑ“ À¡“¬∑’˰”Àπ¥‰«â „π·ºπæ—≤π“ “∏“√≥ ÿ¢ ©∫—∫∑’Ë 9 ‡¥Á°∑’Ë®–‡µ‘∫‚µ‡ªìπºŸâ„À≠à∑’Ë¡’§ÿ≥¿“æ ´÷ËßµâÕ߉¥â √—∫°“√æ—≤π“µ—Èß·µà „π§√√¿å¡“√¥“ À≠‘ßµ—Èß§√√¿å·≈– “¡’§«√¡’§«“¡√Ÿâ ∑—»π§µ‘ ∑’Ë¥’ „π°“√¥Ÿ·≈√–À«à“ßµ—Èß §√√¿å·≈–°“√§≈Õ¥ ‡æ◊ËÕ®–‰¥â𔉪ªØ‘∫—µ‘ ‡π◊ËÕß®“°„π — ß §¡ªí ® ®ÿ ∫ — π ‚§√ß √â “ ß§√Õ∫§√— « ¢Õß§π‰∑¬‡ªì π §√Õ∫§√—«‡¥’ˬ« ∑”„À⢓¥‚Õ°“ „π°“√‰¥â√—∫§«“¡√Ÿâ ®“°≠“µ‘ºŸâ „À≠à §«“¡√Ÿâ®÷ßµâÕ߇ªìπ°“√»÷°…“¥â«¬µπ‡Õß À√◊Õ Õ∫∂“¡®“°‡æ◊ËÕπ∫â“π ´÷Ëß∫“ß ‘Ëß∂Ÿ°µâÕß ∫“ß ‘Ë߉¡à ∂Ÿ°µâÕß ¥—ßπ—πÈ °“√‰¥â√∫— §«“¡√Ÿ®â “°∫ÿ§≈“°√∑“ß°“√·æ∑¬å ·≈– “∏“√≥ ÿ¢®÷ß¡’§«“¡ ”§—≠Õ¬à“߬‘Ëß∑’Ë®–™à«¬‡À≈◊Õ „π°“√¥Ÿ·≈√–À«à“ßµ—ßÈ §√√¿å·≈–°“√§≈Õ¥Õ¬à“ß¡’§≥ ÿ ¿“æ ‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 3 ®÷ß ‰¥â®—¥°‘®°√√¡§≈‘π‘°æàÕ·¡à§π‡°àß ´÷Ë߇ªìπ°“√∫√‘°“√∑’Ë ®—¥¢÷Èπ‡ √‘¡®“°§≈‘π‘°Ω“°§√√¿åµ“¡ª°µ‘ ”À√—∫°“√„Àâ §«“¡√Ÿâ·°àÀ≠‘ßµ—Èß§√√¿å·≈– “¡’ „π ¿“æ·«¥≈âÕ¡∑’Ë ‡À¡“– ¡ ‡Õ◊ÈÕµàÕ°“√‡√’¬π√Ÿâ ‚¥¬§“¥«à“ “¡’∑’Ë√à«¡√—∫ øíß§«“¡√Ÿâ‡°’ˬ«°—∫°“√¥Ÿ·≈°“√µ—Èß§√√¿å·≈–°“√§≈Õ¥ ¢ÕßÀ≠‘ßµ—Èß§√√¿å ®–𔉪ªØ‘∫—µ‘ àߺ≈„ÀâÀ≠‘ßµ—Èß§√√¿å ‰¥â√—∫°“√¥Ÿ·≈Õ¬à“߇À¡“– ¡ ®π∫√√≈ÿπ‚¬∫“¬ ≈Ÿ°‡°‘¥ √Õ¥ ·¡àª≈Õ¥¿—¬ “¬ —¡æ—π∏å·¡à-≈Ÿ° √«¡∑—È߇¥Á°¡’ æ—≤π“°“√ ¡«—¬∑—Èߥâ“𠵑ªí≠≠“ √à“ß°“¬·≈–Õ“√¡≥å °“√»÷°…“π’È¡’«—µ∂ÿª√– ß§å ‡æ◊ËÕ»÷°…“ §«“¡√Ÿâ ªï∑’Ë 23 ©∫—∫∑’Ë 2 ‡¡.¬. - ¡‘.¬. 2549 ∑—»π§µ‘¢ÕßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’„π‡√◊ËÕß°“√¥Ÿ·≈ªØ‘∫—µ‘ µπ√–À«à“ßµ—Èß§√√¿å·≈–°“√§≈Õ¥°àÕπ·≈–À≈—߉¥â√—∫ °“√ Õπ ÿ¢»÷°…“ √«¡∂÷ß§«“¡æ÷ßæÕ„®µàÕ√Ÿª·∫∫°“√ „Àâ ÿ¢»÷°…“„π§≈‘π‘°æàÕ·¡à§π‡°àß ‚¥¬§“¥«à“Õ—µ√“°“√ ¢“¥ÕÕ°´‘‡®π„π∑“√°·√°‡°‘¥·≈–∑“√°·√°‡°‘¥πÈ” Àπ—°µ—«πâÕ¬®–≈¥≈ß «‘∏°’ “√»÷°…“ ‡ªìπ°“√«‘®¬— °÷ßË ∑¥≈Õß·∫∫»÷°…“°≈ÿ¡à ‡¥’¬««—¥º≈ °àÕπ·≈–À≈—ß°“√„Àâ ÿ¢»÷°…“ (The single group pretest post-test design) „π§≈‘π‘°æàÕ·¡à§π‡°àß ‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 3 °≈ÿࡵ—«Õ¬à“ß À≠‘ßµ—Èß§√√¿å∑’Ë¡“√—∫∫√‘°“√Ω“°§√√¿å „π‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ µ—Èß·µà«—π∑’Ë 1 ¡‘∂ÿπ“¬π æ.». 2547 ∂÷ß«—π∑’Ë 31 µÿ≈“§¡ æ.». 2547 ‚¥¬¡’≈—°…≥–¥—ßπ’È ‡°≥±å§—¥‡≈◊Õ°‡¢â“‡ªìπ°≈ÿà¡»÷°…“ (inclusion criteria) 1. ¬‘π¬Õ¡‡¢â“√à«¡„π‚§√ß°“√§√—ßÈ ·√°‡¡◊ÕË Õ“¬ÿ §√√¿å < 16 —ª¥“Àå 2. “¡’Õ“»—¬Õ¬Ÿ√à «à ¡°—∫À≠‘ßµ—ßÈ §√√¿åµ≈Õ¥°“√ µ—Èß§√√¿å®π∂÷ß§≈Õ¥ 3. “¡’¬‘π¬Õ¡‡¢â“√à«¡°‘®°√√¡µà“ß Ê µ“¡ °√–∫«π°“√«‘®—¬ µ≈Õ¥®π∂÷ß°“√§≈Õ¥∫ÿµ√ ‡°≥±å§—¥ÕÕ°®“°°≈ÿà¡»÷°…“ (exclusion criteria) 1. À≠‘ßµ—ßÈ §√√¿å∑·Ë’ ®âß§«“¡®”πß∑’®Ë –‰¡à¡“§≈Õ¥ ∫ÿµ√∑’Ë‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ 2. À≠‘ßµ—Èß§√√¿å∑’Ë·∑âß∫ÿµ√ µ√«®æ∫∑“√°‡ ’¬ ™’«‘µ„π§√√¿å «‘∏’°“√¥”‡π‘π°“√«‘®—¬ 1. Õ∏‘∫“¬·π«∑“ß°“√«‘®—¬√«¡∑—Èߪ√–‚¬™πå∑’Ë ®–‰¥â√—∫®“°°“√«‘®—¬„ÀâÀ≠‘ßµ—Èß§√√¿å·≈– “¡’∑√“∫ ‡¡◊ËÕ ‰¥â√—∫§«“¡¬‘π¬Õ¡ ®÷ß„ÀâÀ≠‘ßµ—Èß§√√¿å·≈– “¡’≈ßπ“¡„π „∫¬‘π¬Õ¡‡¢â“√à«¡°“√«‘®—¬ 2. À≠‘ßµ—Èß§√√¿å·≈– “¡’ ∑”·∫∫∑¥ Õ∫ J Prapokklao Hosp Clin Med Educat Center 77 Vol. 23 No. 2 Apr. - Jun. 2006 §«“¡√Ÿâ·≈–∑—»π§µ‘ ·∫∫∫—π∑÷°¢âÕ¡Ÿ≈∑—Ë«‰ª 3. „Àâ ÿ¢»÷°…“À≠‘ßµ—Èß§√√¿å·≈– “¡’ ‡ªìπ°≈ÿà¡ ·∫àß°≈ÿ¡à µ“¡™à«ßÕ“¬ÿ§√√¿å „°≈⇧’¬ß°—π °≈ÿ¡à ≈–‰¡à‡°‘π 14 §π ‚¥¬«‘∏’°“√∫√√¬“¬ °“√Õ¿‘ª√“¬ °“√ “∏‘µ Ωñ° ªØ‘∫—µ‘ÕÕ°°”≈—ß°“¬ ·≈–°“√‡√’¬π√Ÿâ·∫∫¡’ à«π√à«¡ ¡’ ‚ª ‡µÕ√å Àÿàπ®”≈Õß «’¥’∑—»πå ‡ªìπ ◊ËÕ°“√ Õπ √–¬– ‡«≈“°“√ Õπ·µà≈–§√—Èߪ√–¡“≥ 30 π“∑’µ“¡·ºπ°“√ Õπ ÿ¢»÷°…“¥—ßπ’È 3.1 Õ“¬ÿ§√√¿å < 28 —ª¥“Àå Õπ °“√ ‡ª≈’ˬπ·ª≈ߢÕß√à“ß°“¬·≈–®‘µ„® °“√¥Ÿ·≈ªØ‘∫—µ‘µπ ¢≥–µ— È ß §√√¿å °“√„™â ¬ “ °“√‡®√‘ ≠ ‡µ‘ ∫ ‚µ·≈– æ—≤π“°“√¢Õß∑“√°„π§√√¿å ‚¿™π“°“√ °“√¥Ÿ·≈ ÿ¢¿“æøíπ √«¡∑—Èß Õπ°“√ÕÕ°°”≈—ß°“¬·≈–∑à“∑“ß °“√∑√ßµ—«∑’Ë∂Ÿ°µâÕß 3.2 Õ“¬ÿ§√√¿å 28 - 36 —ª¥“Àå Õπ°“√ ‡ª≈’¬Ë π·ª≈ߢÕß√à“ß°“¬ °“√¥Ÿ·≈ªØ‘∫µ— µ‘ π¢≥–µ—ßÈ §√√¿å °“√‡®√‘≠‡µ‘∫‚µ·≈–æ—≤π“°“√¢Õß∑“√°„π§√√¿å „π ™à«ßÕ“¬ÿ§√√¿åπ’È °“√‡µ√’¬¡µ—« ”À√—∫°“√‡≈’Ȭß≈Ÿ°¥â«¬ π¡·¡à °“√π—∫‡¥Á°¥‘Èπ 3.3 Õ“¬ÿ§√√¿å > 36 —ª¥“Àå Õπ°“√ ¥Ÿ·≈µπ‡Õß·≈–°“√‡µ√’¬¡µ—« ”À√—∫°“√§≈Õ¥ —≠≠“≥ ‡µ◊Õπ§≈Õ¥ °“√§≈Õ¥∫ÿµ√«‘∏’µà“ß Ê ¿“«–·∑√°´âÕπ À≈—ß§≈Õ¥ 4. À≠‘ßµ—ßÈ §√√¿å·≈– “¡’∑”·∫∫ª√–‡¡‘π§«“¡ æ÷ßæÕ„®À≈—ß®“°‰¥â√—∫ ÿ¢»÷°…“∑ÿ°§√—Èß 5. À≠‘ßµ—ßÈ §√√¿å·≈– “¡’∑”·∫∫∑¥ Õ∫§«“¡ √Ÿâ·≈–∑—»π§µ‘ (‡¥‘¡) À≈—ß§≈Õ¥∫ÿµ√ 6. ‡®â“Àπâ“∑’Ë∫—π∑÷°¢âÕ¡Ÿ≈∑“ß Ÿµ‘»“ µ√å °“√«‘‡§√“–Àå¢âÕ¡Ÿ≈„™â ‚ª√·°√¡§Õ¡æ‘«‡µÕ√å ”‡√Á®√Ÿª ‚¥¬À“§à“√âÕ¬≈– §à“‡©≈’ˬ à«π‡∫’ˬ߇∫π ¡“µ√∞“π paired sample t-test º≈°“√»÷°…“ ºŸâ√—∫∫√‘°“√Ω“°§√√¿å√“¬„À¡à „π™à«ß√—∫ ¡—§√ ºŸâ‡¢â“„π°“√«‘®—¬¡’ 246 §π À≠‘ßµ—Èß§√√¿å∑’Ë¡’≈—°…≥– µ√ßµ“¡‡°≥±å§—¥‡≈◊Õ°‡¢â“‡ªìπ°≈ÿà¡»÷°…“ 69 §π ·≈â« µ—¥ÕÕ°µ“¡‡°≥±å§¥— ÕÕ°®“°°≈ÿ¡à »÷°…“ 12 §π ©–π—πÈ ¡’ À≠‘ß µ—Èß§√√¿å∑’Ë “¡’¡’ à«π√à«¡µ≈Õ¥°√–∫«π°“√ 57 §π §‘¥‡ªìπ√âÕ¬≈– 23.2 ¢ÕߺŸâ√—∫∫√‘°“√Ω“°§√√¿å√“¬„À¡à ∑—ßÈ À¡¥ µ“√“ß∑’Ë 1 ®”π«π·≈–√âÕ¬≈–¢ÕßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’®”·π°µ“¡Õ“¬ÿ Õ“™’æ °“√»÷°…“ À≠‘ßµ—Èß§√√¿å ®”π«π (§π) √âÕ¬≈– Õ“¬ÿ (ªï) Õ“™’æ °“√»÷°…“ “¡’ ®”π«π (§π) √âÕ¬≈– < 20 21 - 25 26 - 30 31 - 35 > 36 ·¡à∫â“π/ æàÕ∫â“π §â“¢“¬ √—∫®â“ß„π·À≈àßÕÿµ “À°√√¡ ¢â“√“™°“√/√—∞«‘ “À°‘® 9 27 12 8 1 16 2 36 3 15.8 47.4 21.0 14.0 1.8 28.1 3.5 63.1 5.3 2 16 18 21 0 0 2 50 5 3.5 28.1 31.6 36.8 0 0 3.5 87.7 8.8 ª√–∂¡»÷°…“ ¡—∏¬¡»÷°…“µÕπµâπ ¡—∏¬¡»÷°…“ µÕπª≈“¬ / ª«™. Õπÿª√‘≠≠“·≈–ª« . ª√‘≠≠“µ√’ 16 15 16 6 4 28.1 26.3 28.1 10.5 7.0 6 12 31 7 1 10.5 21.0 54.4 12.3 1.8 78 «“√ “√»Ÿπ¬å°“√»÷°…“·æ∑¬»“ µ√å§≈‘π‘° ‚√ßæ¬“∫“≈æ√–ª°‡°≈â“ ªï∑’Ë 23 ©∫—∫∑’Ë 2 ‡¡.¬. - ¡‘.¬. 2549 µ“√“ß∑’Ë 2 ®”π«π·≈–√âÕ¬≈–¢ÕßÀ≠‘ßµ—Èß§√√¿å®”·π°µ“¡¢âÕ¡Ÿ≈∑“ß Ÿµ‘»“ µ√å ¢âÕ¡Ÿ≈∑“ß Ÿµ‘»“ µ√å °“√µ—Èß§√√¿å ≈—°…≥–§√Õ∫§√—« °“√Ω“°§√√¿å§√∫‡°≥±å 4 §√—Èß «‘∏’°“√§≈Õ¥∫ÿµ√ ®”π«π (§π) §√√¿å·√° §√√¿åÀ≈—ß §√Õ∫§√—«‡¥’ˬ« §√Õ∫§√—«¢¬“¬ §√∫ ‰¡à§√∫ §≈Õ¥ª°µ‘∑“ß™àÕß§≈Õ¥ §≈Õ¥¥â«¬‡§√◊ËÕߥŸ¥ ÿ≠≠“°“» ºà“µ—¥§≈Õ¥∫ÿµ√∑“ßÀπâ“∑âÕß 1. ¢âÕ¡Ÿ≈∑—Ë«‰ª·≈–¢âÕ¡Ÿ≈∑“ß Ÿµ‘»“ µ√å À≠‘ßµ—Èß§√√¿å∑ÿ°§π‰¡à¡’Õ“°“√º‘¥ª°µ‘¢≥–µ—Èß §√√¿å ‰¡àæ∫‚√§µ‘¥µàÕ∑“ß‡æ» —¡æ—π∏宓°°“√µ√«®‡≈◊Õ¥ ‰¡àæ∫‚√§‡∫“À«“π·≈–¿“«–§«“¡¥—π‚≈À‘µ Ÿß¢≥–µ—ßÈ §√√¿å 2. ¢âÕ¡Ÿ≈πÈ”Àπ—°·≈–¿“«–°“√¢“¥ÕÕ°´‘‡®π ¢Õß∑“√°·√°‡°‘¥ ∑“√°‡°‘¥¡’™’æ 57 §π ∑“√°¡’πÈ”Àπ—°·√°‡°‘¥ πâÕ¬°«à“ 2,500 °√—¡®”π«π 2 §π ∑“√°¡’§à“ APGAR score ∑’Ë 1 π“∑’ ‡∑à“°—∫ 7 À√◊յ˔°«à“ ®”π«π 2 §π ¥—ßÈ π—πÈ Õ—µ√“∑“√°·√°‡°‘¥πÈ”Àπ—°πâÕ¬ ‡∑à“°—∫ √âÕ¬≈– 3.5 ·≈–Õ—µ√“°“√¢“¥ÕÕ°´‘‡®π„π∑“√°·√°‡°‘¥ ‡∑à“°—∫ 38 19 47 10 55 2 44 5 8 √âÕ¬≈– 66.7 33.3 82.5 17.5 96.5 3.5 77.2 8.8 14.0 35.1 : 1000 °“√‡°‘¥¡’™’æ 3. ¢âÕ¡Ÿ≈§«“¡√Ÿâ ∑—»π§µ‘¢ÕßÀ≠‘ßµ—Èß§√√¿å ·≈– “¡’ §«“¡√Ÿâ ·≈–∑—»π§µ‘°Õà π‰¥â√∫— ÿ¢»÷°…“∑’ÀË ≠‘ß µ—ßÈ §√√¿å·≈– “¡’µÕ∫∂Ÿ°µâÕßπâÕ¬∑’Ë ÿ¥ §◊Õ ¢≥–µ—Èß§√√¿å ‡¡◊ËÕÕ“¬ÿ§√√¿å¡“°°«à“ 32 —ª¥“Àå ∑“√°„π§√√¿å¥‘Èπ Õ¬à“ßπâÕ¬ 10 §√—Èß µàÕ«—π ·≈– ¡’§«“¡‡¢â“„®«à“°“√ «¡‡ ◊ÈÕºâ“√—¥µ—«µ“¡ ¡—¬π‘¬¡∑’ˬ◊¥‰¥â∫â“߉¡à¡’º≈‡ ’¬µàÕ °“√µ—Èß§√√¿å ‡∑à“°—∫ √âÕ¬≈– 56.5 ·≈– 62.3 ¢ÕßÀ≠‘ß µ—ßÈ §√√¿å·≈– “¡’∑∑Ë’ ”·∫∫∑¥ Õ∫°àÕπ°“√„Àâ ¢ÿ »÷°…“ 69 §Ÿà µ“¡≈”¥—∫ µ“√“ß∑’Ë 3 ‡ª√’¬∫‡∑’¬∫§«“¡·µ°µà“ß§–·ππ‡©≈’¬Ë ¢Õß§«“¡√Ÿâ ∑—»π§µ‘¢ÕßÀ≠‘ßµ—ßÈ §√√¿å·≈– “¡’√–À«à“ß°àÕπ·≈–À≈—ß °“√„Àâ ÿ¢»÷°…“ §«“¡√Ÿâ·≈–∑—»π§µ‘ §–·ππ§«“¡√Ÿâ°àÕπ„Àâ ÿ¢»÷°…“ X 11.3 S.D. 16.3 2.2 §–·ππ∑—»π§µ‘°àÕπ„Àâ ÿ¢»÷°…“ 12.8 2.4 17.9 p-value -14.0 0.000 -11.8 0.000 2.4 §–·ππ§«“¡√ŸâÀ≈—ß„Àâ ÿ¢»÷°…“ §–·ππ∑—»π§µ‘À≈—ß„Àâ ÿ¢»÷°…“ t-test 2.2 Vol. 23 No. 2 Apr. - Jun. 2006 J Prapokklao Hosp Clin Med Educat Center 79 5. ¢âÕ¡Ÿ≈§«“¡æ÷ßæÕ„®¢ÕßÀ≠‘ßµ—ßÈ §√√¿å·≈– “¡’µàÕ√Ÿª·∫∫°“√„Àâ ÿ¢»÷°…“ µ“√“ß∑’Ë 4 §–·ππ§«“¡æ÷ßæÕ„®¢ÕßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’À≈—ß°“√„Àâ ÿ¢»÷°…“ °“√„Àâ ÿ¢»÷°…“ X Õ“¬ÿ§√√¿å < 28 —ª¥“Àå Õ“¬ÿ§√√¿å 28-36 —ª¥“Àå Õ“¬ÿ§√√¿å > 36 —ª¥“Àå °“√ÕÕ°°”≈—ß°“¬ Õ“¬ÿ§√√¿å Òˆ-Ú¯ —ª¥“Àå «‘®“√≥å ¢âÕ¡Ÿ≈∑—Ë«‰ª¢ÕßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’‡ª√’¬∫ ‡∑’¬∫°—∫¢âÕ¡Ÿ≈ ∂‘µ‘À≠‘ßµ—Èß§√√¿å·≈– “¡’∑’ËΩ“°§√√¿å ‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ ªï æ.». 25472 æ∫«à“ °≈ÿà¡ µ—«Õ¬à“ß ¡’≈—°…≥–§≈⓬°—π à«π„À≠à‡ªìπ§√Õ∫§√—«‡¥’ˬ« ∑”ß“π√—∫®â“ß„π‚√ßß“πÕÿµ “À°√√¡ ¡’√“¬‰¥â 7,500 10,000 ∫“∑µàÕ‡¥◊Õπ “¡’¢ÕßÀ≠‘ßµ—Èß§√√¿å¡“√à«¡øíß ÿ¢»÷°…“‰¥â ‡¡◊ËÕ‡ √Á®ß“π∑’Ë∑”°≈“ß§◊π‡ªìπ à«π„À≠à ´÷Ëß πà“®–Õπÿ¡“π‰¥â«à“ “¡’¢ÕßÀ≠‘ßµ—Èß§√√¿å „π°≈ÿà¡π’È¡’§«“¡ π„®¥â«¬µ—«¢Õßµπ‡Õߥ⫬ ·¡â«à“À≠‘ßµ—Èß§√√¿å·≈– “¡’ ®–‰¥â√—∫°“√ Õπ ÿ¢»÷°…“·µà°Á¬—ßæ∫«à“¡’°“√Ω“°§√√¿å ‰¡à§√∫ 4 §√—Èß µ“¡‡°≥±å √âÕ¬≈– 3.5 ‡π◊ËÕß®“°°≈—∫ µà“ß®—ßÀ«—¥∑”∏ÿ√– ”§—≠ °“√ Õπ ÿ¢»÷°…“‡°’ˬ«°—∫°“√¥Ÿ·≈√–À«à“ßµ—Èß §√√¿å·≈–°“√§≈Õ¥ ∑”„ÀâÀ≠‘ßµ—Èß§√√¿å·≈– “¡’ ‡°‘¥ §«“¡§‘¥§«“¡‡™◊ËÕ„À¡à À√◊Õ‚¬°§≈Õπ§«“¡‡™◊ËÕ‡¥‘¡ Õ—π ®–π”‰ª Ÿà°“√¡’∑—»π§µ‘∑’Ë∂Ÿ°µâÕßµ“¡¡“ æ∫«à“ §–·ππ §«“¡√Ÿâ ·≈–∑—»π§µ‘ ¢ÕßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’À≈—ß°“√ „Àâ ÿ¢»÷°…“ Ÿß°«à“°àÕπ°“√„Àâ ÿ¢»÷°…“Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ ∑’Ë√–¥—∫ P < .05 ‡π◊ÈÕÀ“§«“¡√Ÿâ≈â«π¡’ §«“¡ ”§—≠ µ√ß°—∫§«“¡µâÕß°“√¢ÕßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’ ´÷Ëß “¡“√∂π”¡“ªØ‘∫—µ‘ ‰¥â «‘∏’°“√ Õπ∫√√¬“¬ ·∫∫查§ÿ¬¡’ªØ‘ —¡æ—π∏å ·≈°‡ª≈’Ë¬π§«“¡§‘¥‡ÀÁπ °“√ “∏‘µ¥â«¬Àÿàπ®”≈Õß ‚ª ‡µÕ√å ™¡«’¥’∑—»πå·≈–°“√ 3.4 3.6 3.5 3.3 §–·ππ§«“¡æ÷ßæÕ„® S.D. ·ª≈º≈(√–¥—∫) 0.3 0.3 0.4 0.3 ¡“° ¡“° ¡“° ¡“° ªØ‘∫—µ‘®√‘ß√à«¡¥â«¬ „π√–¬–‡«≈“∑’ˇÀ¡“– ¡ ∑”„ÀâÀ≠‘ß µ—Èß§√√¿å·≈– “¡’¡’§«“¡ π„®µ≈Õ¥‡«≈“ º≈°“√»÷ ° …“π’ È Õ¥§≈â Õ ß°— ∫ °“√»÷ ° …“¢Õß Sukomal P. ·≈–§≥–3 æ∫«à“À≠‘ßµ—Èß§√√¿å·≈– “¡’ 48 §Ÿà´÷Ë߇ªìπ°≈ÿà¡»÷°…“ ¡’§–·ππ§«“¡√Ÿâ ·≈–∑—»π§µ‘À≈—߉¥â √—∫ ÿ¢»÷°…“¡“°°«à“°àÕπ‰¥â√—∫ ÿ¢»÷°…“ Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ ·µàÀ≠‘ßµ—Èß§√√¿å·≈– “¡’ 52 §Ÿà ´÷Ëß ‡ªìπ°≈ÿà¡§«∫§ÿ¡ (‰¡à ‰¥â√—∫°“√ Õπ ÿ¢»÷°…“) ¡’§–·ππ §«“¡√Ÿâ·≈–∑—»π§µ‘∑—Èß 2 §√—Èß·µ°µà“ßÕ¬à“߉¡à¡’π—¬ ”§—≠∑“ß ∂‘µ‘ √«¡∑—Èßæ∫«à“ “¡’¢Õß°≈ÿà¡∑’Ë ‰¥â√—∫ ÿ¢ »÷°…“‰¥âπ”§«“¡√Ÿâ ‰ªªØ‘∫µ— °‘ ∫— À≠‘ßµ—ßÈ §√√¿å·≈– à߇ √‘¡ π—∫ πÿπ„ÀâÀ≠‘ßµ—Èß§√√¿åªØ‘∫—µ‘µπ„Àâ∂Ÿ°µâÕß¡“ «à“ “¡’ ¢Õß°≈ÿà¡∑’Ë ‰¡à ‰¥â√—∫ ÿ¢»÷°…“ Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ °“√»÷°…“¢Õß Abundis R. ·≈–§≥–4 ‡°’ˬ«°—∫ √Ÿª·∫∫°“√„Àâ ÿ¢»÷°…“„πÀ≠‘ßµ—Èß§√√¿å‡ªìπ°≈ÿà¡ æ∫«à“ À≠‘ßµ—Èß§√√¿å¡’§«“¡√Ÿâ ∑—»π§µ‘·≈–°“√ªØ‘∫—µ‘µπ∑’Ë¥’ ·≈–¡’¢âÕ·π–π”«à“§«√„Àâ “¡’¢ÕßÀ≠‘ßµ—Èß§√√¿å‡¢â“√à«¡ øíߥ⫬®–‡°‘¥º≈¥’¡“°¢÷Èπ “¡’≈¥°“√ Ÿ∫∫ÿÀ√’Ë≈ß ™à«¬¥Ÿ ·≈·≈– à߇ √‘¡À≠‘ßµ—Èß§√√¿å „ÀâªØ‘∫—µ‘µπÕ¬à“߇À¡“– ¡ ·≈–¡’§«“¡√ŸâæÕ∑’Ë®–‡ªìπ∑’˪√÷°…“¢ÕßÀ≠‘ßµ—Èß§√√¿å „π °√≥’©ÿ°‡©‘π∑’˵âÕßµ—¥ ‘π„®„π°“√√—°…“∑—π∑’ °“√»÷°…“¢Õß Nichols5 ‡ªìπ°“√»÷°…“‡ª√’¬∫ ‡∑’¬∫√–À«à“ßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’∑’Ë ‰¥â√—∫°“√ Õπ ÿ¢ »÷°…“ °—∫ °≈ÿ¡à ∑’¡Ë ·’ µàÀ≠‘ßµ—ßÈ §√√¿å ‰¥â√∫— °“√ Õπ ÿ¢»÷°…“ 80 «“√ “√»Ÿπ¬å°“√»÷°…“·æ∑¬»“ µ√å§≈‘π‘° ‚√ßæ¬“∫“≈æ√–ª°‡°≈â“ æ∫«à“ °≈ÿà¡ “¡’∑’Ë ‰¥â√—∫ ÿ¢»÷°…“¡’√–¥—∫§«“¡√Ÿâ¡“°°«à“ Õ’°°≈ÿà¡ ·≈–„Àâ§«“¡ π„®¥Ÿ·≈À≠‘ßµ—Èß§√√¿å√–À«à“ß µ—Èß§√√¿å §≈Õ¥ ·≈–À≈—ß§≈Õ¥¡“°°«à“·µà ‰¡à·µ°µà“ß Õ¬à“ß¡’π—¬ ”§—≠ °≈ÿà¡ “¡’∑’Ë ‰¥â√—∫ ÿ¢»÷°…“®–¡’§«“¡ π„®»÷°…“ À“§«“¡√Ÿâ‡æ‘Ë¡‡µ‘¡‡°’ˬ«°—∫°“√¥Ÿ·≈∑“√° ·√°‡°‘¥ ¢âÕ¡Ÿ≈ ∂‘µ‘ À≠‘ßµ—Èß§√√¿å∑’ËΩ“°§√√¿å·≈–§≈Õ¥ ∫ÿµ√„π‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ2 „π™à«ß√–¬–‡«≈“ ‡¥’¬«°—π°—∫°“√∑”«‘®¬— ´÷ßË ‰¡à√«à ¡„π§≈‘π°‘ æàÕ·¡à§π‡°àß 173 §π æ∫Õ—µ√“∑“√°·√°‡°‘¥πÈ”Àπ—°πâÕ¬ √âÕ¬≈– 6.4 ·≈–Õ—µ√“°“√¢“¥ÕÕ°´‘‡®π„π∑“√°·√°‡°‘¥ 17.3 : 1000 °“√‡°‘¥¡’™’æ ªí®®—¬∑’Ë∑”„Àâ∑“√°·√°‡°‘¥πÈ”Àπ—°πâÕ¬6,7 ‡™àπ °“√§≈Õ¥°àÕπ°”Àπ¥ §√√¿å·Ω¥ ¿“«–·∑√°´âÕπ ¢≥–µ—Èß§√√¿å Õ“À“√ °“√ Ÿ∫∫ÿÀ√’Ë ¥◊Ë¡ ÿ√“ °“√‡¥‘π∑“ß °“√∑”ß“π §«“¡ Ÿß πÈ”Àπ—° ¥—™π’¡«≈°“¬ ·≈–æ—π∏ÿ °√√¡ ªí®®—¬¥—ß°≈à“«‰¡à “¡“√∂§«∫§ÿ¡‰¥â „π°“√∑”«‘®—¬ ®“°º≈°“√»÷°…“ æ∫ Õ—µ√“∑“√°·√°‡°‘¥πÈ”Àπ—°πâÕ¬ √âÕ¬≈– 3.5 ´÷ËßπâÕ¬°«à“°≈ÿà¡À≠‘ßµ—Èß§√√¿å∑’Ë ‰¡à√à«¡„π §≈‘π‘°æàÕ·¡à§π‡°àß ´÷ËßÕ“®‡π◊ËÕß®“° °≈ÿà¡»÷°…“¡’§«“¡ ‡Õ“„®„ àµàÕ°“√¥Ÿ·≈§√√¿å ‰¥âπ”§«“¡√Ÿâ¥â“π‚¿™π“°“√ ∑’Ë ‰¥â√—∫‰ªªØ‘∫—µ‘Õ¬à“߇À¡“– ¡ À√◊ÕÕ“®‡ªìπ®“°¢π“¥ °≈ÿࡵ—«Õ¬à“ßπâÕ¬‡°‘π‰ª°Á ‰¥â °“√»÷°…“‚¥¬π”¢âÕ¡Ÿ≈®“°ß“π«‘®¬— À≈“¬ Ê ß“π ¡“√«¡°—π·≈–«‘‡§√“–Àå „À¡à (meta-analysis) ¢Õß WHO æ∫«à“ °“√„Àâ§«“¡√Ÿâ∑“ß‚¿™π“°“√·¥àÀ≠‘ßµ—Èß§√√¿å ‰¡à “¡“√∂ √ÿª ‰¥â«à“¡’ª√–‚¬™πåÀ√◊Õ‰¡àµàÕ¡“√¥“ ·≈–πÈ” Àπ—°∑“√°·√°‡°‘¥8 ®“°º≈°“√»÷°…“ Õ—µ√“°“√¢“¥ÕÕ°´‘‡®π„π ∑“√°·√°‡°‘¥ 35.1 : 1000 °“√‡°‘¥¡’™’æ ´÷Ëß¡“°°«à“ °≈ÿà¡À≠‘ßµ—Èß§√√¿å∑’Ë ‰¡à√à«¡„π§≈‘π‘°æàÕ·¡à§π‡°àß ªí®®—¬ ‡ ’¬Ë ß∑’ÕË “®°àÕ„À⇰‘¥¿“«–∑“√°·√°‡°‘¥¢“¥ÕÕ°´‘‡®π9,10 ‡™àπ ‚√§ª√–®”µ—« ¿“«–·∑√°´âÕπ¢≥–µ—Èß§√√¿å §«“¡ º‘¥ª°µ‘¢Õß∑“√°„π§√√¿å °“√„™â Ÿµ‘»“ µ√åÀ—µ∂°“√ ¿“«–©ÿ°‡©‘π ™—° ¡¥≈Ÿ°·µ° ‡ªìπµâπ ªí®®—¬∑’Ë “¡“√∂ ªÑÕß°—π ·°â ‰¢‰¥â °Á “¡“√∂∑’Ë®–π”§«“¡√Ÿâ¥—ß°≈à“« Õπ ·¥à À≠‘ßµ—Èß§√√¿å·≈– “¡’ à«π∑’˪ÑÕß°—π‰¡à ‰¥â µâÕß ªï∑’Ë 23 ©∫—∫∑’Ë 2 ‡¡.¬. - ¡‘.¬. 2549 æ—≤𓇮â“Àπâ“∑’Ë “∏“√≥ ÿ¢„Àâ¡’§«“¡√Ÿâ °“√µ—¥ ‘π„® ªØ‘∫—µ‘°“√∑’Ë∑—π∑à«ß∑’ ·≈–‡À¡“– ¡°—∫°√≥’©ÿ°‡©‘π µà“ß Ê ©–π—Èπ ®÷߉¡à “¡“√∂ √ÿª ‰¥â ‚¥¬µ√ß«à“°“√‰¥â√—∫ ÿ¢»÷°…“¡’º≈µàÕ°“√¢“¥ÕÕ°´‘‡®π„π∑“√°·√°‡°‘¥ À≠‘ßµ—ßÈ §√√¿å·≈– “¡’¡§’ «“¡æ÷ßæÕ„®µàÕ√Ÿª·∫∫ °“√„Àâ ÿ¢»÷°…“ „π√–¥—∫¡“°∑ÿ°‡√◊ËÕß ´÷Ëßπà“®–Õ∏‘∫“¬ ‰¥â«à“ ‡π◊ÈÕÀ“∑ÿ°‡√◊ËÕß∑’Ë®—¥„π√Ÿª·∫∫°“√„Àâ ÿ¢»÷°…“ ¡’ §«“¡ ”§—≠·≈– “¡“√∂𔉪ªØ‘∫—µ‘ ‰¥â®√‘ß µ√ß°—∫ §«“¡µâÕß°“√¢ÕßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’ «‘∏’°“√ Õπ ‡πâπ°“√‡√’¬π√Ÿâ·∫∫¡’ à«π√à«¡·≈–°“√ Õπ‡ªìπ°≈ÿà¡¡’º≈ ∑”„ÀâÀ≠‘ßµ—Èß§√√¿å·≈– “¡’π”ª√– ∫°“√≥凥‘¡¢Õß µπ‡Õß¡“·≈°‡ª≈’ˬπ®πæ—≤π“„À⇰‘¥§«“¡√Ÿâ„À¡à ¡’°“√ „™â ◊ËÕ∑’ˇÀ¡“– ¡™à«¬„Àâ “¡“√∂ Õπ‡π◊ÈÕÀ“‰¥â§√∫„𠇫≈“∑’˰”Àπ¥ °“√ÕÕ°°”≈—ß°“¬„πÀ≠‘ßµ—Èß§√√¿å®– ™à«¬Ωñ°°“√À“¬„® ¡’º≈„ÀâÀ≠‘ßµ—Èß§√√¿å¡’§«“¡¡—Ëπ„®„π °“√§≈Õ¥∫ÿµ√∑“ß™àÕß§≈Õ¥ ≈¥§«“¡°—ß«≈‰¥â ‚¥¬®– æ∫«à“°“√§≈Õ¥ª°µ‘∑“ß™àÕß§≈Õ¥„π°“√»÷°…“π’È ‡∑à“°—∫ √âÕ¬≈– 77.2 °“√§≈Õ¥º‘¥ª°µ‘‡ªìπ°“√¥Ÿ·≈µ“¡¢âÕ∫àß™’È ∑“ß°“√·æ∑¬å √ÿª·≈–¢âÕ‡ πÕ·π– §≈‘π°‘ æàÕ·¡à§π‡°à߇ªìπ√Ÿª·∫∫°“√„Àâ ¢ÿ »÷°…“ ·°àÀ≠‘ßµ—Èß§√√¿å ·≈– “¡’ ∑’ˇ √‘¡¢÷Èπ®“°§≈‘π‘°Ω“° §√√¿åª°µ‘ ‚¥¬¡’‡π◊ÕÈ À“‡©æ“–°“√¥Ÿ·≈À≠‘ßµ—ßÈ §√√¿åª°µ‘ æ∫«à“À≠‘ßµ—Èß§√√¿å·≈– “¡’¡’§«“¡√Ÿâ ∑—»π§µ‘ „π°“√ ¥Ÿ·≈µ—Èß§√√¿å ·≈–°“√§≈Õ¥ ¡“°°«à“°àÕπ„Àâ ÿ¢»÷°…“ Õ¬à“ß¡’π¬— ”§—≠ Õ—µ√“∑“√°·√°‡°‘¥πÈ”Àπ—°πâÕ¬°«à“ 2,500 °√—¡ √âÕ¬≈– 3.5 Õ—µ√“°“√¢“¥ÕÕ°´‘‡®π„π∑“√°·√° ‡°‘¥ 35.1 : 1000 °“√‡°‘¥¡’™’æ À≠‘ßµ—Èß§√√¿å·≈– “¡’ ¡’§«“¡æ÷ßæÕ„®¡“°°—∫√Ÿª·∫∫°“√„Àâ ÿ¢»÷°…“π’È ß“π «‘®—¬π’ȵ√–Àπ—°∂÷ß§«“¡ ”§—≠¢Õß “¡’ ∑’Ë¡’ à«π™à«¬„π °“√‡µ√’¬¡§«“¡æ√âÕ¡∑—Èߥâ“π√à“ß°“¬·≈–®‘µ„®¢Õß À≠‘ßµ—Èß§√√¿å ‚¥¬ºà“π∑“ß°“√„Àâ ÿ¢»÷°…“ ©–π—Èπ®÷ßπà“ ®–𔉪ªØ‘ ∫ — µ ‘ „ π ∂“π∫√‘ ° “√ “∏“√≥ ÿ ¢ Õ◊ Ë π ‚¥¬ π—∫ πÿπ„Àâ¡’ºŸâ√à«¡„π‚§√ß°“√¡“°¢÷Èπ ·≈–§«√¡’°“√ »÷°…“‡ª√’¬∫‡∑’¬∫º≈≈—æ∏å µàÕ∑“√°·√°‡°‘¥ À√◊Õ¥â“π Vol. 23 No. 2 Apr. - Jun. 2006 ®‘µ„® ∑—°…–°“√ªØ‘∫—µ‘¢ÕßÀ≠‘ßµ—Èß§√√¿å·≈– “¡’ ®“° °“√„Àâ ÿ¢»÷°…“√–À«à“ßÀ≠‘ßµ—Èß§√√¿å∑’Ë¡’·≈–‰¡à¡’ “¡’ ‡¢â“√à«¡øíß ÿ¢»÷°…“ √«¡∑—Èßπà“®–¡’°“√»÷°…“√Ÿª·∫∫ °“√„Àâ ÿ¢»÷°…“·°àÀ≠‘ßµ—Èß§√√¿å∑’Ë¡’¿“«–·∑√°´âÕπ‡æ‘Ë¡ ¢÷πÈ µàÕ‰ª °‘µµ‘°√√¡ª√–°“» ¢Õ¢Õ∫§ÿ≥ºŸâÕ”π«¬°“√»Ÿπ¬åÕπ“¡—¬∑’Ë 3 ∑’Ë π—∫ πÿπ°“√∑”«‘®—¬ §ÿ≥√—µπ“ ‡æ™√æ√√≥ §ÿ≥§«√æ‘» “¬¿—∑√“πÿ √≥å ∑’Ë„Àâ§”™’·È π– ·≈–‡®â“Àπâ“∑’Ë‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ ∑ÿ°∑à“π∑’Ë ‰¥â ≈–‡«≈“‡¢â“√à«¡ª√–™ÿ¡ ·≈– Õπ ÿ¢»÷°…“„π‚§√ß°“√®π ”‡√Á®≈ÿ≈à«ß‰ª¥â«¬¥’ ‡Õ° “√Õâ“ßÕ‘ß 1. ¢âÕ¡Ÿ≈Õπ“¡—¬·¡à·≈–‡¥Á°ª√–‡∑»‰∑¬ 2545. °√¡ Õπ“¡—¬ °√–∑√«ß “∏“√≥ ÿ¢ 2. ∂‘µ‘ª√–®”ªï 2546 ·≈– 2547. √“¬ß“πº≈ß“π·≈– ∂‘µ‘‚√ßæ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 3 3. 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J Med Assoc Thai 1992; 75:578-583. 7. πƒ∑∏‘Ï Õâπæ√âÕ¡. °“√»÷°…“¬âÕπÀ≈—ß ‘∫ “¡ªï ‡°’ˬ«°—∫∑“√°πÈ”Àπ—°µ—«πâÕ¬∑’Ë ‚√ßæ¬“∫“≈æ√–π— Ë ß ‡°≈â “ . «“√ “√°ÿ ¡ “√‡«™»“ µ√å 2537;33: 181-91. 8. The WHO Reproductive Health Library, No 3. Geneva: World Health Organization, 2000 9. ‡¬◊ÕÈ π µ—ππ‘√π— ¥√. ¿“«–·Õ æ‘°‡´’¬„π√–¬–‡®Á∫§√√¿å §≈Õ¥·≈–‡¡◊ËÕ·√°‡°‘¥. „π : π‡√»√ ÿ¢‡®√‘≠. ∫√√≥“∏‘°“√. Theme çNew Trends in O&Gé. æ‘¡æå§√—Èß∑’Ë 1. °√ÿ߇∑æ¡À“π§√ : ¿“ææ‘¡æå, 2548: 93-102. 10. Pelowski A, Finer NN. Birth asphyxia in the term infant. In: Sinclair J, Lucey J, editors. Effective care of the newborn infant. Oxford : Oxford University Press, 1992:263-6.
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