晚期早产儿精神运动发育早期干预效果研究  

Effect of early intervention on mental and motor development in late preterm infants

作　　者：王婷雪[1] 李蓓[2] 徐兵[1] 胡雯[1] 蒋齐安[1] 徐秀[2] 

机构地区：[1]上海市浦东新区妇幼保健院儿童保健科,中国上海201206 [2]复旦大学附属儿科医院儿童保健科,中国上海201102

出　　处：《教育生物学杂志》2015年第2期71-75,共5页Journal of Bio-education

基　　金：上海市浦东新区科委创新基金(PKJ2012-Y33)

摘　　要：目的评价早期干预对晚期早产儿(late preterm infants,LPIs)精神运动发育的影响。方法 207例LPIs根据随访时间先后和家长自愿的原则分为LPIs干预组(122例)和LPIs对照组(85例),另选取54例足月儿(full-term infants,FTIs)为FTIs组。对三组进行定期随访,并对LPIs干预组实施早期干预。于矫正(3±0.7)、(6±0.7)、(12±0.7)月龄对三组采用贝莉婴儿发育量表-Ⅱ进行评估,计算精神发育指数(mental development index,MDI)和心理运动发育指数(psychomotor development index,PDI);对LPIs干预组母亲进行依从性调查问卷分析。结果 LPIs干预组、LPIs对照组和FTIs组分别有83例、42例和43例完成随访。LPIs干预组PDI、MDI随月龄增加呈上升趋势,3月龄时LPIs干预组PDI、MDI与LPIs对照组比较差异无统计学意义(P>0.05),6、12月龄时LPIs干预组PDI、MDI显著大于LPIs对照组(P<0.05);各月龄LPIs干预组和LPIs对照组PDI、MDI均显著小于FTIs组(P<0.05)。LPIs干预组母亲依从性调查问卷结果显示,医师注重疏导家长的焦虑情绪等因素有助家长定期随访。结论 LPIs认知、运动水平低于FTIs,对LPIs早期干预可有效提高其精神运动发育水平,对LPIs的早期干预方案有待进一步完善。Objective To investigate the effect of early intervention on mental and motor development in late preterm infants（LPIs）. Methods Two hundred and seven LPIs were divided into LPIs intervention group（122 cases）and LPIs control group（85 cases） based on the time of follow-up and voluntariness of parents,and another 54 full-term infants（ FTIs） were served as FTIs group. Follow-up was carried out in three groups,and early intervention was conducted in LPIs intervention group. Assessments were performed in three groups at corrected ages of（3 ± 0.7）,（6 ±0.7） and（12 ± 0.7） months using the Bayley Scales of Infant Development,Second Edition,and mental development index（MDI） and psychomotor development index（PDI） were calculated. Questionnaire survey on compliance was done among mothers in LPIs intervention group,and the results were analyzed. Results A complete follow-up was done in 83 cases in LPIs intervention group,42 cases in LPIs control group and 43 cases in FTIs group. The PDI and MDI values gradually increased with ages in LPIs intervention group. There was no significant difference in PDI and MDI values between LPIs intervention group and LPIs control group at the age of 3 months（ P〉0.05）,while the PDI and MDI values in LPIs intervention group were significantly higher than those in LPIs control group at the age of 6 and 12 months（ P〈0.05）. The PDI and MDI values in LPIs intervention group and LPIs control group were significantly lower than those in FTIs group at the age of 3,6 and 12 months（ P〈0.05）. Questionnaire survey on compliance in LPIs intervention group indicated that the role of doctors in relieving the anxiety of parents helped the parents to complete the routine follow-up. Conclusion The cognitive and motor development of LPIs lags behind FTIs. Early intervention may improve the cognitive and motor development of LPIs. The early intervention program for LPIs remains to be perfected.

关 键 词：晚期早产儿 早期干预 认知发展 

分 类 号：R722.6[医药卫生—儿科]