VLBWI和ELBWI神经发育预后的影响因素和个体化随访管理模式的效果  

Influencing factors of neurodevelopmental prognosis of VLBWI and ELBWI and the effect of individual follow-up management model

作　　者：鲁萍[1] 周迎春[1] 吕俊英[1] 余海英[1] 罗荣眉[1] 王建平[1] LU Ping;ZHOU Ying-Chun;LYU Jun-Ying(Department of Neonatology,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第二医院新生儿科,浙江温州325000

出　　处：《中国妇幼保健》2021年第7期1533-1536,共4页Maternal and Child Health Care of China

基　　金：浙江省卫生计生委医药卫生科技计划项目(2018KY524)。

摘　　要：目的分析极低出生体质量儿(VLBWI)和超低出生体质量儿(ELBWI)神经发育预后的影响因素和个体化随访管理模式的效果。方法选取2015年1月1日-2016年12月31日温州医科大学附属第二医院新生儿科收治的80例VLBWI和ELBWI为对照组,2017年9月1日-2018年9月30日收治的84例VLBWI和ELBWI为观察组。收集患儿相关临床资料。所有患儿随访到2周岁时,使用Gesell发育量表评估神经发育预后。对照组采用常规随访管理模式。观察组采用个体化随访管理模式。结果164例VLBWI和ELBWI随访到2周岁时,Gesell评分异常率为16.5%(27/164)。多因素Logistic回归分析显示:胎龄、1 min Apgar评分、机械通气史、母亲年龄、妊娠期并发症是VLBWI和ELBWI神经发育预后的影响因素。两组患儿2周岁时适应性、精细运动、语言功能评分比较差异均有统计学意义(均P<0.05)。结论VLBWI和ELBWI神经发育预后受胎龄、1 min Apgar评分、机械通气史、母亲年龄、妊娠期并发症影响,个体化随访管理模式可减少神经发育异常发生率,改善VLBWI和ELBWI神经发育预后。Objective To analyze the influencing factors of neurodevelopmental prognosis of very low birth weight infant(VLBWI)and extremely low birth weight infant(ELBWI)and the effect of individual follow-up management model.Methods Eighty VLBWI and ELBWI treated in Department of Neonatology in the Second Affiliated Hospital of Wenzhou Medical University from January 1 st,2015 to December 31 st,2016 were selected as control group,eighty VLBWI and ELBWI from September 1 st,2017 to September 30 th,2018 were selected as observation group.The related clinical data of infants in the two groups were collected,all the infants were followed up for two years,Gesell Development Scale was used to evaluate neurodevelopmental prognosis.VLBWI and ELBWI in control group were given routine followup management model;VLBWI and ELBWI in observation group were given individual follow-up management model.Results All the infants were followed up for two years,the abnormal rate of Gesell score was 16.5%(27/164).Multivariate Logistic regression analysis showed that fetal age,one-minute Apgar score,history of mechanical ventilation,maternal age,and pregnancy complications were influencing factors of neurodevelopmental prognosis.There were statistically significant differences in the scores of adaptability,fine motor,and language function when the infants were aged two years old(P<0.05).Conclusion Neurodevelopmental prognosis of VLBWI and ELBWI is affected by fetal age,one-minute Apgar score,history of mechanical ventilation,maternal age,and pregnancy complications,individual follow-up management model can reduce the incidence rate of neurodevelopmental abnormalities and improve neurodevelopmental prognosis of VLBWI and ELBWI.

关 键 词：极低出生体质量儿 超低出生体质量儿 神经发育 预后 随访管理 影响因素 

分 类 号：R179[医药卫生—妇幼卫生保健]