早期干预对早产儿认知发育的影响  

Influence of early intervention on cognitive development of early and late preterm infants

作　　者：孙燕 张瑜平 贾文智 蒯烨滨 肖海燕 李玖玲 李海欣 SUN Yan;ZHANG Yuping;JIA Wenzhi;JIN Yebin;XIAO Haiyan;LI Jiuling;LI Haixin(Changzhou Maternal and Child Health Care Hospital,Jiangsu Changzhou 213003,China)

机构地区：[1]常州市妇幼保健院,江苏常州213003

出　　处：《中国妇幼健康研究》2019年第3期275-278,共4页Chinese Journal of Woman and Child Health Research

基　　金：南京医科大学科技发展基金资助项目(2014NJMU019)

摘　　要：目的探讨早期干预对早、晚期早产儿认知发育的影响,建立早产儿随访管理体系,探索有效的早期干预技术,改善早产儿预后。方法收集2016年1月1日至6月30日在常州市妇幼保健院儿保科早产儿高危儿门诊就诊出生的早产儿95例进行追踪随访,其中早期早产儿55例,晚期早产儿40例。所有研究对象于纠正胎龄满40周时进行新生儿行为神经评估(NBNA),早期早产儿作为实验组,根据NBNA评估结果,制定感知功能及运动功能的个体化早期干预方案,实行家庭-医院-家庭早期干预模式,晚期早产儿作为对照组进行常规被动操干预指导。所有研究对象于纠正胎龄6个月时应用Gesell发育量表进行发育评估。结果 95例早产儿的NBNA评估结果显示:早期早产儿的发育程度显著落后于晚期早产儿(χ~2=12.671,P=0.001)。通过一段时间的干预,早期早产儿在Gesell发育量表的"大运动行为"、"语言行为"及"个人社交行为"亚量表的评分显著优于晚期早产儿(t值分别为3.846、3.499、2.018,均P<0.05)。结论基于NBNA评估的早期干预可有效改善早产儿预后,但是晚期早产儿也必须给予足够重视。Objective To investigate the influence of early intervention on the cognitive development of early and late preterm infants so as to establish a preterm follow-up management network for exploring effective early intervention and improving infants' prognosis.Methods Ninety-five cases of preterm infants born in the period of January 1 to June 30 in 2016 were followed up,including 55 early preterm infants and 40 late preterm infants.All subjects were assessed by neonatal behavioral neurological assessment (NBNA) when their corrected gestational ages were 40 weeks.According to the assessment results,individualized early intervention program including perceptive function and motor function was formulated for early preterm infants to realize a family-hospital-family early intervention model.And late preterm infants who acted as controls conducted routine passive exercises intervention.Eventually,all infants were assessed by Gesell developmental schedules when their corrected gestational ages were 6 months.Results According to the NBNA assessment of 95 preterm infants,the development of late preterm infants was better developed than that of early preterm infants (χ 2=12.671, P =0.001).When assessed by Gesell,the developmental quotient of gross motor,language and individuality in late preterm infants was significantly lower than that of early preterm infants ( t value was 3.846,3.499 and 2.018,respectively,all P <0.05).Conclusion The prognosis of preterm infants can be improved by early intervention based on the results of NBNA.Besides,late preterm infants must be given enough attention.

关 键 词：早期早产儿 晚期早产儿 认知发育 早期干预 

分 类 号：R722.6[医药卫生—儿科]