出院后规范随访监控机制对早产儿生长发育的影响  

Effect of standardized follow-up monitoring system after discharge on premature infantile growth and development

作　　者：高晓燕 冯琳[2] 邱玉芬[2] 陈玉君[1] GAO Xiaoyan;FENG Lin;QIU Yufen;CHEN Yujun(Department of Neonatology,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,Guangxi,China;Department of Neonatology,Maternity and Child Health Care of Guangxi Zhuang Autonomous Region,Nanning 530003,Guangxi,China)

机构地区：[1]广西医科大学第二附属医院新生儿科,广西南宁市530007 [2]广西壮族自治区妇幼保健院新生儿科,广西南宁市530003

出　　处：《广西医学》2023年第1期39-44,50,共7页Guangxi Medical Journal

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016087)。

摘　　要：目的建立早产儿出院后规范随访监控机制,分析该管理模式下早产儿生长发育情况,为制订合理的营养支持和早期神经干预策略提供理论依据。方法依据出生胎龄、出生体重及临床特征将613例早产儿分为高危早产儿与低危早产儿。对高危早产儿与低危早产儿分别制订随访计划表并定期评估,根据其生长发育情况给予相应干预,根据出院后是否定期回院随访分为规范随访组和非规范随访组。比较两组早产儿出院时、校正12~24月龄的体重Z值、身长Z值、头围Z值;比较两组早产儿校正0月龄、1月龄时的新生儿神经行为测定(NBNA)评分;比较早产儿校正3月龄、12~24月龄的Gesell发育量表评估情况。结果(1)在校正12~24月龄时,两组高危早产儿的体重Z值、身长Z值和头围Z值均较出院时增大,且规范随访组高危早产儿上述Z值的增长量均大于非规范随访组高危早产儿(均P<0.05);但各组内低危早产儿的体重Z值、身长Z值和头围Z值与出院时比较差异均无统计学意义(均P>0.05),且两组之间低危早产儿上述Z值的增长量差异亦均无统计学意义(均P>0.05)。(2)校正1月龄时,两组高危早产儿和两组低危早产儿的NBNA评分均较校正0月龄时增加,且规范随访组高危早产儿的NBNA评分高于非规范随访组高危早产儿(均P<0.05),但两组低危早产儿的NBNA评分比较差异无统计学意义(P>0.05)。(3)校正3月龄时,规范随访组高危早产儿的大动作发育迟缓率低于非规范随访组高危早产儿(P<0.05);两组低危早产儿的适应性行为、大运动、精细动作、语言、个人社交行为发育迟缓率比较,差异均无统计学意义(均P>0.05)。校正12~24月龄时,两组高危早产儿及两组低危早产儿的适应性行为、大运动、精细动作、语言、个人社交行为发育迟缓率均低于校正3月龄时,且规范随访组高危早产儿及低危早产儿的上述5个能区的发育迟缓率均Objective To establish a standardized follow-up monitoring system of premature infants after discharge,and to analyze the condition of premature infantile growth and development under the management mode,so as to provide theoretical basis for formulating reasonable nutritional support and early neurological intervention strategies.Methods A total of 613 premature infants were assigned to high-risk premature infants or low-risk premature infants according to birth gestational age,birth weight and clinical features.The follow-up schedules on high-risk premature infants and low-risk premature infants were formulated,respectively,and the premature infants were evaluated periodically,as well as corresponding interventions were given to them according to the condition of growth and development,and then they were divided into standardized follow-up group or non-standardized follow-up group according to whether they returned to hospital for regular follow-up or not after discharge.The Z values of body weight,body length,and head circumference were compared between the premature infants at discharge and at corrected age of 12 to 24 months,the Neonatal Behavioral Neurological Assessment(NBNA)score was compared between the premature infants at corrected age of 0 month and 1 month,and the evaluation status of the Gesell development scale was compared between the premature infants at corrected age of 3 months and 12 to 24 months.Results(1)At the corrected age of 12 to 24 months,the Z values of body weight,body length,and head circumference of high-risk premature infants in both groups were enlarged as compared with at discharge,and the high-risk premature infants of the standardized follow-up group obtained larger increase in Z values of aforesaid indices compared with high-risk premature infants of the non-standardized follow-up group(all P<0.05);however,no statistically significant difference in the Z values of body weight,body length,and head circumference was found as compared with at discharge in the low-risk premature i

关 键 词：早产儿 出院后随访 规范管理 生长发育 神经发育 

分 类 号：R722[医药卫生—儿科]