NICU出院高危新生儿不同月龄神经精神发育特征分析  

Analysis on neuropsychic development characteristics of high-risk neonates discharged from NICU

作　　者：田园[1] 章春草 郑小斐[1] 刘烽 王莎莎 于广军[1] TIAN Yuan;ZHANG Chun-Cao;ZHENG Xiao-Fei(Children's Hospital of Shanghai,Shanghai,200040,China)

机构地区：[1]上海市儿童医院

出　　处：《中国妇幼保健》2019年第22期5191-5195,共5页Maternal and Child Health Care of China

基　　金：上海市科学技术委员会2017年度“科技创新行动计划”社会发展领域项目科研计划项目(17511108902);上海市科学技术委员会2018年度上海市优秀学术技术带头人计划(18XD1403200)

摘　　要：目的定量和定性分析NICU出院高危儿6和18月龄神经精神发育特征,为开展高危儿发育监测和早期干预提供依据。方法对2013年1月-2017年12月出生并在上海市儿童医院高危儿随访门诊接受系统管理的高危新生儿进行随访,采用Gesell婴幼儿发育量表评估6和18月龄高危儿神经精神发育情况,分析不同分组高危儿发育特征。结果 6月龄共488例高危儿纳入分析,18月龄共294名高危儿纳入分析。6和18月龄时各组高危儿各能区发育商(DQ)均值可达量表平均值范围。6月龄男童不同出生胎龄(GA)分组的应物能、言语能、应人能DQ值差异均有统计学意义(均P<0. 05)。18月龄不同GA高危儿4个能区DQ值差异无统计学意义(P>0. 05),但与神经精神功能表现密切的运动能、应物能区,仍以晚期早产男童组DQ值最低。结论 NICU出院高危新生儿精神发育存在性别、出生胎龄间的差异;即使平均DQ达量表平均值范围,这一群体神经精神发育风险仍较高,且不同年龄高危儿侧重不同能区;需重点监测中期、晚期早产男童,持续开展家长教育和干预。Objective To quantitatively and qualitatively analyze the characteristics of neuropsychic development of high-risk neonates discharged from NICU,provide a basis for conducting developmental monitoring and early intervention of high-risk neonates. Methods The high-risk neonates born in Children’s Hospital of Shanghai from January 2013 to December 2017 and undergoing system management in Outpatient were followed up, Gesell Developmental Scale was used to assess neuropsychic development of high-risk neonates at 6 and18 months,the neuropsychic development characteristics of high-risk infants in different groups were analyzed. Results A total of 488 high-risk infants at 6 months and 294 high-risk infants at 18 months were enrolled in this study. The mean values of development quotient( DQ)of different domains in high-risk infants at 6 and 18 months reached the average value of the scales. There were statistically significant differences in DQs of response to object,language,and response to person in 6-month-old boys among different gestational age groups( P <0. 05). There was no statistically significant difference in DQs of four domains in 18-month-old high-risk neonates among different gestational age groups( P>0. 05). DQs of exercise and response to object closely related to neuropsychic function were the lowest in late premature boys. Conclusion Neuropsychic development of high-risk neonates discharged from NICU has differences of gender and gestational age,even if the average values of DQ reach the average value of the scales,neuropsychic development risk is high among these high-risk neonates,which focuses on different domains of high-risk neonates in different age groups. The mid-term and late-term premature boys should be closely monitored,and parent education should be continuously carried out.

关 键 词：NICU 高危新生儿 神经精神发育 特征 

分 类 号：R722.1[医药卫生—儿科]