1岁内高危儿神经发育及影响因素分析  

Analysis of neurodevelopment and influencing factors of high-risk infants within 1 year old

作　　者：李佳敏 贾旭凤 吴郝娟 李桦[2] 朱华[2] 许文明[3] 谢江 LI Jiamin;JIA Xufeng;WU Haojuan;LI Hua;ZHU Hua;XU Wenming;XIE Jiang(School of Clinical Medicine,Southwest Medical University,Luzhou 646000,Sichuan Province,China;Third People s Hospital of Chengdu,Chengdu 610031,Sichuan Province,China;West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]西南医科大学临床医学院,中国泸州646000 [2]成都市第三人民医院,中国成都610031 [3]四川大学华西第二医院,中国成都610041

出　　处：《教育生物学杂志》2021年第3期184-190,共7页Journal of Bio-education

基　　金：四川省卫生健康委员会科研课题(19PJ009)。

摘　　要：目的研究1岁内高危儿的神经发育情况,分析可能的影响因素。方法收集2017年6月—2019年1月在成都市第三人民医院儿童保健科建立健康档案的92例高危儿(年龄或矫正月龄为12个月)的资料,记录高危儿的性别、出生胎龄、出生体质量、新生儿期疾病及其母亲孕期疾病等信息,对不同影响因素下高危儿6月龄、12月龄的Gesell发育量表5个能区的发育商(developmental quotient,DQ)结果进行分析。结果与6月龄时比较,高危儿12月龄时的大运动、精细动作、适应性、个人社交DQ值均显著提高,差异有统计学意义(P<0.05);语言DQ值的差异无统计学意义(P>0.05)。高危儿在多能区的DQ值随出生胎龄、出生体质量的减小而降低,差异具有统计学意义(P<0.05)。出生胎龄<32周、出生体质量<1.5 kg的高危儿12月龄时,各能区DQ值仍低于85。在有新生儿肺炎、支气管肺发育不良、消化道出血、新生儿呼吸窘迫综合征等疾病的高危儿中,12月龄时DQ值低于85的比例较高,差异有统计学意义(P<0.05)。结论小胎龄和低体质量是导致1岁内高危儿神经发育落后的重要因素。1岁内高危儿在语言能区的追赶趋势相对其他能区要弱,需引起重视并加强监测与干预。新生儿肺炎、支气管肺发育不良、消化道出血、新生儿呼吸窘迫综合征是神经发育不良的潜在危险因素,应加强对新生儿疾病的防控。Objective To study the neurodevelopment of high-risk infants within 1 year old,and analyze the possible influencing factors.Methods The clinical data of 92 high-risk infants(at the age or corrected age of 12 months)who had health records in the Third People’s Hospital of Chengdu from June 2017 to January 2019 were collected.And their data of gender,gestational age,birth weight,neonatal diseases,and maternal diseases during pregnancy were recorded.The developmental quotient(DQ)scores of five function areas in Gesell developmental scale at corrected age of 6 months and 12 months were analyzed under different developmental factors.Results The DQ scores of gross motor,fine motor,adaptability,and individual social behavior in high-risk infants at the age of 12 months were significantly higher than those at the age of 6 months(P<0.05).There was no significant difference in language DQ scores(P>0.05).The DQ scores of high-risk infants significantly reduced as gestational age and birth weight decreased in multiple function areas(P<0.05).With gestational age less than 32 weeks and birth weight less than 1.5 kg,the DQ scores of high-risk infants at 12 months in multiple function areas were still lower than 85.With neonatal pneumonia,bronchopulmonary dysplasia,gastrointestinal hemorrhage,and neonatal respiratory distress syndrome,the proportion of 12-month-old high-risk infants whose DQ scores were lower than 85 was higher(P<0.05).Conclusion Low gestational age and low birth weight are important factors that lead to the lag of neurodevelopment of high-risk infants within 1 year old.In the first year,the catch-up trend in the language of high-risk infants is weaker than other function areas,and we need to pay attention and strengthen monitoring and intervention.Neonatal pneumonia,bronchopulmonary dysplasia,gastrointestinal hemorrhage,and neonatal respiratory distress syndrome are the potential risk factors for neurological abnormality,and the prompt prevention and control of neonatal diseases should be strengthened.

关 键 词：神经发育 GESELL发育量表 发育商 高危儿 

分 类 号：R722.1[医药卫生—儿科]