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目的分析早产儿和足月儿神经发育结局,探讨高危儿门诊对早产儿早期神经发育干预的作用,为临床早期干预提供一定依据。方法选择2008—2011年在我院高危儿门诊规律随访的早产儿为观察组,随机抽取同期在本院儿童保健门诊保健的健康足月儿为对照组,在早产儿校正年龄/足月儿生后年龄3个月、6个月时分别进行Gesell测试和DDST筛查,评估并比较两组婴儿的神经发育。结果校正年龄3个月时,早产儿大运动、语言、适应性与个人社交落后于足月儿[(62.2±22.7)分比(82.6±20.0)分,(91.8±49.3)分比(117.0±22.5)分,(63.1±29.5)分比(88.7±19.4)分,(66.5±35.7)分比(92.2±17.5)分,P均<0.05],两组精细运动差异无统计学意义(P>0.05);校正年龄6个月时,早产儿大运动、精细运动、语言、适应性、个人社交等发育商与足月儿差异均无统计学意义(P>0.05)。早产儿校正年龄6个月时大运动、适应性和个人社交发育商与校正年龄3个月时相比均提高,差异有统计学意义(P<0.05)。结论早产儿早期发育商水平低于足月儿,尤其是大运动、语言、适应性和个人社交落后于足月儿。通过早期干预,早产儿发育商后期能追赶上足月儿。应重视早产儿出院后干预,促进早产儿潜在能力得到最大程度的发挥。
Objective To analyze the effect of neurological development in preterm and term infants, and to explore the effect of high-risk infants clinics on early neuropsychological intervention in preterm infants, so as to provide some evidences for early clinical intervention. Methods The preterm infants who were followed up in our hospital from 2008 to 2011 were selected as the observation group. Healthy full-term infants in the health care outpatient department of our hospital were randomly selected as the control group. The corrected age / full-term infants Gesell test and DDST screening were performed at the age of 3 months and 6 months respectively to evaluate and compare the neurological development of infants in both groups. Results After adjustment for age at 3 months, the prevalence of major motor, language, adaptability and individual social lagging in full-term infants was significantly higher than that of full-term infants (62.2 ± 22.7, 82.6 ± 20.0, 91.8 ± 49.3, 117.0 ± 22.5), (63.1 ± 29.5) points (88.7 ± 19.4) points, (66.5 ± 35.7) points (92.2 ± 17.5) points respectively (all P <0.05). There was no significant difference in fine motor between the two groups (P> 0.05). There was no significant difference in developmental age and full-term infants in preterm infants with large movement, fine motor movement, language, adaptability, individual social development at 6 months of age correction (P> 0.05). Compared with the adjusted age of 3 months, the adjusted exercise age, adaptability and individual social development in preterm infants with a corrected age of 6 months were significantly increased (P <0.05). Conclusions The level of early developmental premature infants is lower than that of full-term infants, especially large-scale exercise, language, adaptability and individual social backwardness. Through early intervention, early stage developmental traders can catch up with full-term infants. Should pay attention to premature children discharge after intervention to promote the potential capacity of preterm children to get the maximum play.