扬州市区新生儿重症监护室出院高危儿早期干预现状及相关影响因素  

Early intervention status and related influencing factors of neonatal intensive care unit discharged high-risk infants in Yangzhou urban area

作　　者：张峰 孟兆祥[1] 金星[1] 舒桂华[2] 朱玲玲[3] 任素伟[1] 侯玮玮[2] 吕媛[2] 周伟[2] 林春[1] 赵婷[4] 陈悦琳 郑京琪 ZHANG Feng;MENG Zhaoxiang;JIN Xing;SHU Guihua;ZHU Lingling;REN Suwei;HOU Weiwei;LYU Yuan;ZHOU Wei;LIN Chun;ZHAO Ting;CHEN Yuelin;ZHENG Jingqi(Department of Rehabilitation Medicine,North Jiangsu People′s Hospital in Jiangsu province,Yangzhou,Jiangsu,225001;Department of Neonatology,North Jiangsu People′s Hospital in Jiangsu province,Yangzhou,Jiangsu,225001;Department of Child Healthcare,North Jiangsu People′s Hospital in Jiangsu province,Yangzhou,Jiangsu,225001;Department of Rehabilitation Medicine,Yangzhou Maternal and Child Health Care Hospital in Jiangsu Province,Yangzhou,Jiangsu,225002;Developmental and Behavioral Child Care Department,Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu,225000;Department of Rehabilitation,Hanjiang District Zhuxi Community Health Service Center of Yangzhou City in Jiangsu Province,Yangzhou,Jiangsu,225012)

机构地区：[1]江苏省苏北人民医院康复医学科,江苏扬州225001 [2]江苏省苏北人民医院新生儿科,江苏扬州225001 [3]江苏省苏北人民医院儿童保健科,江苏扬州225001 [4]江苏省扬州市妇幼保健院康复医学科,江苏扬州225002 [5]扬州大学附属医院发育行为儿童保健科,江苏扬州225000 [6]江苏省扬州市邗江区竹西社区卫生服务中心康复科,江苏扬州225012

出　　处：《实用临床医药杂志》2023年第11期80-84,88,共6页Journal of Clinical Medicine in Practice

摘　　要：目的探讨扬州市区新生儿重症监护室(NICU)出院高危儿早期干预现状,并分析其相关影响因素。方法选取高危儿200例作为研究对象。在患儿纠正3个月龄时,对其父母采用统一问卷进行调查。分析高危儿早期干预的相关影响因素。结果200例高危儿中,未接受早期干预101例,接受早期干预99例。接受早期干预的99例高危儿中,选择机构早期干预5例,选择家庭早期干预94例。9家庭早期干预的4例高危儿中,在综合医院接受早期干预指导92例,在社区医院接受早期干预指导2例。截至患儿纠正3月龄,其父母接受早期干预指导的情况为1次85例、2次5例、≥3次4例。2组患儿在出生周龄、出生体质量、高危儿认知、后遗症认知、早期干预认知、接受神经发育评估与否、随访医生告知早期干预与否、知晓早期干预机构与否和经济负担方面比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,后遗症认知了解(OR=7.300,95%CI:2.641-20.178)、随访医生告知早期干预(OR=10.793,95%CI:2.926-39.805)、知晓早期干预机构(OR=7.212,95%CI:2.043-25.458)是扬州市区NICU出院高危儿接受早期干预的保护因素。结论扬州市区NICU出院高危儿接受早期干预的影响因素中,家长对后遗症认知了解、随访医生告知早期干预和知晓早期干预机构是保护因素,以上3种影响因素在高危儿早期干预工作中需要被重视。Objective To investigate the status quo of early intervention for discharged high-risk infants in neonatal intensive care unit(NICU)in Yangzhou urban area,and analyze the related influencing factors.Methods A total of 200 high-risk infants were selected as research objects.At 3 months of adjusted age,parents were surveyed with a uniform questionnaire.Factors influencing early intervention of high-risk infants were analyzed.Results Among the 200 high-risk children,101 did not receive early intervention(did not receive early intervention group)and 99 received early intervention.Among 99 high-risk children who received early intervention,5 cases chose institutional early intervention and 94 cases chose family early intervention.Among the 4 high-risk children with 9 family early intervention,92 cases received early intervention guidance in general hospital and 2 cases received early intervention guidance in community hospital.Up to 3 months of adjusted age,the number of parents receiving early intervention guidance was 85 cases for 1 time,5 cases for 2 times and 4 cases for≥3 times.There were statistically significant differences between the two groups in age at birth,birth weight,cognition of high-risk infants,cognition of sequelae,cognition of early intervention,neurodevelopmental evaluation,follow-up of doctors to inform early intervention,knowledge of early intervention institutions and economic burden(P<0.05).Multivariate Logistic regression analysis showed that sequelae cognition(OR=7.300;95%CI,2.641 to 20.178),early intervention informed by follow-up doctors(OR=10.793;95%CI,2.926 to 39.805),early intervention institutions(OR=7.212;95%CI,2.043 to 25.458)were protective factors for early intervention of NICU discharged high-risk children in Yangzhou urban area.Conclusion Among the influencing factors of early intervention for NICU discharged high-risk children in Yangzhou urban area,parents′cognitive understanding of sequelae,doctors′notification of early intervention and awareness of early intervention in

关 键 词：高危儿 早期干预 后遗症 颅内出血 缺血缺氧性脑病 

分 类 号：R472[医药卫生—护理学] R72[医药卫生—临床医学]