基于多学科合作的早产儿随访门诊建立改进及其前后对照研究  

Construction and the improvement effect of a multidisciplinary follow-up clinic for high-risk preterm infants

作　　者：胡晓琳[1] 陈玲[1] 罗小平[1] 孟玉石 刘晶 高金枝[1] 刘利英 HU Xiao-lin;CHEN Ling;LUO Xiao-ping;MENG Yu-shi;LIU Jin;GAO Jin-zhi;LIU Li-ying(Tongji Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院儿科,武汉湖北430030

出　　处：《中国儿童保健杂志》2020年第8期895-899,共5页Chinese Journal of Child Health Care

基　　金：湖北省卫生健康委员会2019-2020年度面上项目(WJ2019M125)。

摘　　要：目的分析实施高危早产儿随访质量改进的效果,为完善多学科合作的早产儿随访体系提供参考。方法选取2017年7月1日-2018年7月31日,从同济医院新生儿科出院的出生胎龄<32周和(或)出生体重<1 500 g的早产儿共268例,纳入高危新生儿随访项目,早期随访患儿为对照组(n=185),给与常规出院指导与随访,后期随访患儿为干预组(n=83),实行随访质量改进措施,比较两组高危早产儿在纠正月龄1个月、3个月及6个月的随访率以及6月龄Gesell评分。结果干预组和对照组患儿随访率在纠正月龄1个月时差异无统计学意义(P>0.05),在3个月、6个月时干预组随访率均较对照组增高,且差异有统计学意义(χ~2=5.307、7.965,P<0.05);纠正月龄6个月时干预组应物能和应人能得分高于对照组,差异有统计学意义(t=2.719、3.661,P<0.05)。纠正月龄1个月、3个月及6个月均规律随访的早产儿,其在大运动及应物能方面得分均高于未按规律随访的患儿(F=8.486、7.056,P<0.05)。结论高危早产儿随访质量改进可提高随访率,间接促进早产儿的神经系统发育。Objective To investigate the effect of the quality improvement program on high-risk infants follow up(HRIF) clinic,in order to provide reference for improving the multidisciplinary follow-up system for high-risk preterm infants. Methods A total of 268 infants with gestational age<32 weeks or birth weight<1 500 g discharged from Tongji Hospital were recruited in a high-risk infant follow-up program from July 1 st 2017 to July 31 st 2018.Infants discharged in early period were defined as control group(n=185) and those discharged later were selected as intervention group(n=83).The control group was given conventional discharge guidance,while the intervention group received multidisciplinary HRIF.The follow-up rates of two groups at the corrected age of 1,3,6 months and Gesell score at the age of 6 months were compared. Results The follow-up rate of the intervention group and control group was not significantly different at the corrected age of 1 month(P>0.05),but the difference was significant at the age of 3 months and 6 months(χ~2=5.307,7.965,P<0.05).Infants in the intervention group had higher scores of cognitive and social functions assessed by Gesell scale at the corrected aged of six months(t=2.719,3.661,P<0.05).Infants,who took regular follow-up at the corrected age of 1,3,6 months,had higher score in gross motor development and cognitive function than those without regular follow-up(F=8.486,7.056,P<0.05). Conclusion The follow-up quality improvement program for high-risk infants increases the follow-up rate and indirectly facilitate the neurodevelopment of premature infants.

关 键 词：高危早产儿 早产儿 新生儿 随访 质量改进 

分 类 号：R473.72[医药卫生—护理学]