规范随访监控机制对高危儿生长发育的影响  

Effect of standardized follow-up monitoring mechanism on the growth and development of high-risk infants

作　　者：王丽[1] 李晨 吕攀攀[3] 崔传英[1] Wang Li;Li Chen;Lyu Panpan;Cui Chuanying(Department of Child Health Care,Binzhou Central Hospital,Binzhou 251700,China;Department of Clinical Lab,Binzhou Central Hospital,Binzhou 251700,China;Department of Child Health Care,Binzhou Medical University Hospital,Binzhou 256600,China)

机构地区：[1]滨州市中心医院儿童保健科,滨州251700 [2]滨州市中心医院检验科,滨州251700 [3]滨州医学院附属医院儿童保健科,滨州256600

出　　处：《国际医药卫生导报》2024年第12期2004-2008,共5页International Medicine and Health Guidance News

基　　金：山东省医药卫生科技发展计划(202006040694);滨州市科技发展计划(2014ZC0155)。

摘　　要：目的通过建立高危儿规范随访监控机制,分析对高危儿生长发育的影响,为制定合理的营养支持和早期干预策略提供依据。方法选取2021年1月至2023年1月滨州市中心医院收治住院的高危儿260例,依据高危儿是否定期返院进行随访分为规范随访组和非规范随访组。规范随访组170例高危儿中男78例,女92例,日龄12(7,14)d,高危因素1项112例、2项58例;非规范随访组90例高危儿中男41例,女49例,日龄13(7,15)d,高危因素1项59例、2项31例。规范随访组是指根据出院随访计划表在出院后定期返院随访,并根据返院的各项检查结果,及时评估并给予干预措施;非规范随访组为出院后未规律返院随访且失访次数>3次,但有2周龄、3月龄、6月龄、12月龄4个时间点的发育评估资料。比较两组高危儿6月龄、12月龄的体格发育情况,2周龄、4周龄时的新生儿神经行为测定(NBNA)评分,3月龄、1月龄的Gesell发育量表评估情况及并发症发生情况。采用t检验、χ^(2)检验、U检验。结果规范随访组高危儿6月龄的身长、体质量和头围分别为(70.4±7.8)cm、(8.7±1.6)kg、(43.4±1.5)cm,12月龄分别为(78.3±6.4)cm、(11.4±1.5)kg、(45.3±1.5)cm,均高于非规范随访组的(62.8±8.7)cm、(7.6±2.3)kg、(41.4±1.1)cm、(76.6±7.6)cm、(10.7±1.9)kg、(44.8±1.6)cm,差异均有统计学意义(t=7.178、P<0.001,t=4.509、P<0.001,t=12.830、P<0.001,t=1.907、P=0.058,t=3.256、P=0.001,t=2.498、P=0.013)。规范随访组高危儿出生2周、4周时NBNA评分分别为(36.67±2.18)分、(38.59±1.61)分,非规范随访组分别为(36.62±2.21)分、(37.73±1.34)分,两组出生4周时NBNA评分均比出生2周时升高,且规范随访组高于非规范随访组,差异均有统计学意义(均P<0.05)。3月龄时,两组高危儿的大运动、精细动作、适应性行为、语言、个人社交发育迟缓率比较,差异均无统计学意义(均P>0.05);12月龄时,两组高危儿的智能发育迟缓率均�Objective By establishing the standardized follow-up monitoring mechanism for high-risk infants,the influence on the growth and development of high-risk infants was analyzed,and the basis for formulating reasonable nutrition support and early intervention strategies was provided.Methods From January 2021 to January 2023,260 high-risk infants were hospitalized in Binzhou Central Hospital.According to whether the high-risk infants returned to hospital regularly for follow-up,they were divided into a standardized follow-up group and a non-standardized follow-up group.In the standardized follow-up group,there were 170 high-risk infants,78 boys and 92 girls,aged 12(7,14)days,112 cases with 1 high-risk factor and 58 cases with 2 high-risk factors.In the non-standardized follow-up group,there were 90 high-risk infants,41 boys and 49 girls,aged 13(7,15)days,59 cases with 1 high-risk factor and 31 cases with 2 high-risk factors.The standardized follow-up group referred to regular return to the hospital after discharge according to the discharge follow-up schedule,and timely assessment and intervention measures were given according to the results of various examinations.In the non-standardized follow-up group,the infants did not return to the hospital regularly after discharge for follow-up and the number of lost visits was>3 times,but there were developmental assessment data at 4 time points of 2 weeks,3 months,6 months,and 12 months old.The physical development of high-risk infants at 6 months and 12 months old were compared between the two groups.The Neonatal Behavioral Neurological Assessment(NBNA)scores at 2 weeks and 4 weeks old were compared between the two groups.The Gesell development scale of 3-month old and 12-month old of high-risk infants were compared.The incidences of complications were compared between the two groups.t test,χ^(2) test,and U test were used.Results The body length,body weight,and head circumference of the high-risk infants in the standardized follow-up group were(70.4±7.8)cm,(8.7±1.6)kg,an

关 键 词：高危儿 随访 规范 体格发育 神经心理发育 

分 类 号：R72[医药卫生—儿科]