早产小于胎龄儿早期干预对体格发育及神经心理发育影响的应用研究

关键词：早产儿  小于胎龄儿  神经心理发育

Keywords:premature infants, small for gestational age infant, neuropsychological development

摘要：

      摘要 目的：研究在NICU病房住院期间及出院后行早期干预对早产小于胎龄儿的体格发育及神经心理发育的影响。 方法：选取2016年7月后在我院住院的早产小于胎龄儿作为研究对象（观察组），住院期间开始早期干预，并于出院后继续给予早期干预到24个月，将此前在我院住院的早产小于胎龄儿但并未实行早期干预措施的患儿作为对照组，记录两组患儿体格发育指标，并于纠正年龄1月、2月、3月、4月、5月时行0—1岁20项神经运动评估（infant neurological motor assessment，INMA），6月、12月、18月、24月龄时应用贝利婴幼儿发育量表Ⅱ（Bayley scales of infant development，BSIDⅡ）进行发育评估，将两组患儿上述检查指标进行对照分析。 结果：①体格发育：矫正年龄6月、12月龄时，体质量、身长比较无显著性意义，但12月龄时两组间头围比较有显著性意义（P<0.05）。矫正年龄18月、24月龄时，体质量、身长及头围两组间比较均有显著性意义（P<0.05）。矫正年龄6月龄后体质量及头围的追赶率观察组较对照组高，矫正年龄18月龄后身长的追赶率观察组亦较对照组高，有显著性意义（P<0.05）；②神经心理发育：矫正年龄6月龄前行INMA提示矫正年龄4月、5月时异常率观察组发生率较对照组低（P<0.05）， 关键年龄行BISDⅡ提示矫正年龄12月龄、18月龄及24月龄时智力发育指数MDI及运动发展指数PDI比较观察组均明显高于对照组（P<0.05）。 结论：在NICU早期介入对早产小于胎龄儿进行早期干预，可以促进其体格发育及神经心理发育，实现良好的成长轨迹。

Abstract:

      Abstract Objective：To study the effect of early intervention on physical and neuropsychological development of preterm small for gestational age infants（SGA）during hospitalization in NICU and after discharge. Method：Premature SGAs hospitalized in neonatal pediatrics from July 2016 were enrolled in the study (observation group).Early intervention program was performed during hospitalization and after discharge untill 24 months. The premature SGAs who were hospitalized in our hospital but not given early intervention measures were taken as the control group. The physical development indexes of the two groups were recorded. The evaluation of 20 items of neuromotor activity between 0—1 year old （INMA） was performed at the correction age of 1、2、3、4、and 5 months，and the developmental evaluation was carried out by Bayley infant development scale（BISDⅡ）at the correction age of 6 and 12、18、24 months. The above indexes were compared and analyzed between the two groups. Result：①Physical development：At the age of 6 and 12 months， there was no significant difference in body mass and body length. However，there was significant difference in head circumference between the two groups at the age of 12 months (P<0.05). At the age of 18、24 months，there were significant differences in body mass，body length and head circumference between the two groups (P<0.05). The catch-up rates of body mass and head circumference in the observation group were higher than those in the control group after 6 months of correction age，and the catch-up rate of body length in the observation group was higher than that in the control group after 18 months of age correction(P<0.05).②Neuropsychological development：the incidence of abnormal rate of INMA in the observation group was lower than that in the control group (P<0.05). The mental development index (MDI) and psychomotor development index (PDI) in the observation group were significantly higher than those in the control group at the age of 12 months, 18 months and 24 months(P<0.05). Conclusion：Early intervention for premature SGAs can promote their physical and neuropsychological development， achieve the development of healthy growth tracks.