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1.
目的:探讨早期干预对高危儿行为发育的效果。方法:将197例高危儿随机分为干预组、未干预组,并设正常婴儿为对照组,参照鲍氏早期教育资料制定干预计划,采用门诊康复训练和家庭干预模式相结合,用Gesell婴幼儿发育检查量表测出两组高危儿的行为发育商(DQ)并作比较,同时还与正常新生儿作比较。结果:1岁时Gesell智能检查结果显示:干预组各行为能区的DQ均大于未组,存在统计学差异(P<0.05),与对照组比较,各行为能区的DQ差异均无显著性。结论:门诊的康复训练和家庭干预模式相结合可以促进高危儿的行为发育,改善其预后。  相似文献   

2.
在NICU中早期干预促进高危儿的神经发育   总被引:3,自引:0,他引:3  
随着各种先进技术的应用,NICU高危儿存活率不断提高.目前关注的焦点多集中在如何维持高危儿的呼吸、心血管、消化、肾脏等重要器官系统的功能上,随访研究表明,高危儿尤其是早产儿有更高的身体残疾、感觉障碍及学习、行为障碍的发生率,针对这种状况,在NICU中早期干预,实施神经保护措施,促进神经发育的重要性正日益受到重视,许多工作正在开展之中,现综述如下.  相似文献   

3.
目的探讨维生素D缺乏状态对高危儿脑损伤的影响。方法鞍山市千山区妇幼保健所于2006-01-2006-12,对大运动发育落后的高危儿163例确诊后,进行骨源性碱性磷酸酶(BALP)检测,发现异常62例。将其随机分为维生素D治疗训练干预组32例及常规训练干预组30例。比较2组患几干预后的临床疗效。结果维生素D佐治组在改善大运动落后、肌张力异常方面有效率明显高于常规干预组(90.6%:70.0%,84.6%:60.0%,均P〈O.05),异常姿势的消失2组间无统计学差异(62.5%:50.0%,P〉O.05)。维生素D缺乏程度与月龄、喂养方式无明显相关性。结论正确补充维生素D是高危儿保健的重要内容。纠正维生素D缺乏状态可提高脑损伤治疗效果,有助于神经运动功能的康复。  相似文献   

4.
目的对农村高危儿出院后给予电话随访式护理干预,提高其生存质量。方法60例农村高危儿分别于出院后第2天、1周、2周、1个月由专科护士给予电话随访式健康指导,对存在的护理问题及时给予护理干预。结果高危儿因各种原因不定期回医院随访的人数由健康指导前的43人减少到5人;经过4次的护理干预后,高危儿出现护理问题明显减少到41人次,1个月后主动去医院随访的人数由健康指导前的17人增加到55人。结论电话随访普及农村高危儿的家庭照顾能力,转变其陈旧的育儿理念,可提高对出院定期、系统随访重要性的认识,提高其生存质量。  相似文献   

5.
《中华围产医学杂志》2007,10(2):144-144
中国优生优育协会儿童发育专业委员会和脑潜能开发委员会于2007年9月4~8日在重庆召开此会。该会已经列入国家继续教育项目。会间邀请美国儿童发育专家Mattew Newell讲<脑潜能开发>,并请国内医学、教育专家黄尚志、李春敏、王惠珊、王丹华、洪昭毅和李晋红等做专题报告,并开设<0  相似文献   

6.
早期综合干预对高危新生儿神经心理发育影响的研究   总被引:13,自引:0,他引:13  
目的 探讨早期综合干预对围产期高危新生儿神经心理发育的效果。 方法 采用自行编写的 0~ 3岁早期干预和早期教育大纲、早期预防感觉统合失调被动按摩操等干预方法 ,对高危干预组儿童进行综合干预 ,另设高危对照组和正常对照组进行比较 ,用Gesell婴幼儿发育量表进行早期神经心理发育监测。 结果 高危干预组各能区发育商 (DQ)和总DQ( 99.84± 15 .72 )均显著大于高危对照组 ( 80 .99± 15 .0 4 ) (P <0 .0 1) ;但与正常对照组 ( 99.2 2± 13.39)比较 ,差异无显著性 (P >0 .0 5 ) ;高危干预组平均DQ <75的比例 ( 1/ 5 8)显著少于高危对照组 ( 8/ 4 2 ) ,差异有显著性 ( χ2 =8.72 8,P <0 .0 5 )。 结论 早期综合干预能促进高危新生儿的神经心理发育。  相似文献   

7.
目的观察早期综合干预对小于胎龄儿生长发育的影响。方法将生后42d的小于胎龄儿80例随机分为干预组和对照组各40例。对照组实施常规现代医学保健,干预组在对照组基础上实施早期综合干预。1周岁时对其身高、体质量测量和智能发育测评。结果干预组患儿体格发育和智能发育均高于对照组,差异有统计学意义(P〈0.001)。结论对于小于胎龄儿这一类存在生长发育障碍的高危儿童,尽早进行干预,能更好地提高其生存质量,防止身材矮小、智力低下的发生。  相似文献   

8.
目前,对卵巢癌高危妇女有两种处理方法:跟踪随访或预防性双侧输卯管卵巢切除术.目的是在高危人群中早期发现或预防卵巢癌(和乳腺癌)。但是,跟踪随访是否使卵巢癌发病率降低仍不清楚,并且很少考虑诸如不必要的手术干预和相关的并发症等负面效应。为此,回顺性研究分析了1994-2000年鹿特丹家族性癌症门诊的资料,  相似文献   

9.
小于胎龄儿体格及智能发育的随访观察   总被引:1,自引:0,他引:1  
  相似文献   

10.
目的探讨营养干预对妊娠期糖尿病(GDM)高危孕妇的发病及生活质量的影响。方法将89例妊娠早期年龄30岁、一级家属有糖尿病史、孕前超重或肥胖、谷类每日600g及水果每日500g的GDM高危因素的孕妇,按自愿原则分为干预组(43例)和对照组(46例)。对照组进行常规产前检查、健康教育及孕期监测,干预组在此基础上从孕早期开始进行个体化营养干预;比较两组GDM发病和健康调查简表评分情况。结果至妊娠结束,对照组发生GDM 17例(36.96%,17/46),干预组发生GDM 3例(6.98%,3/43),两组比较,差异有统计学意义(P0.05)。干预组健康调查简表中,生理功能、躯体疼痛、社交功能和情感职能评分分别是(78.37±14.95)分、(96.07±13.81)分、(100.87±14.01)分和(76.74±32.15)分,与对照组比较,差异有统计学意义(P0.05)。结论营养干预可能对改善GDM高危孕妇的生活质量起到一定的作用。  相似文献   

11.
目的:探讨规范管理和早期干预对高危新生儿智能发育的影响。方法:随机将76例分配为两组,其中44例为高危新生儿干预组,32例为高危新生儿未干预组。两组患儿的围产期情况和环境因素相似。结果:干预组智能发育指数(MDI)和运动发育指数(PDI)均显着高于对照组;神经系统后遗症发生率明显低于对照组。结论:规范管理和早期干预对高危新生儿智能发育有明显的促进作用。  相似文献   

12.
Objective.?To assess the effect of the mode of delivery (vaginal or cesarean section) on survival, morbidity, and long-term psychomotor development of extremely low birth weight (ELBW) infants.

Methods.?A longitudinal observational study including 138 ELBW infants (73 born by c-section and 65 vaginally) was conducted. We analyzed the survival and short-term morbidity. We also studied the long-term neurocognitive and motor development using the McCarthy Scales of Children's Abilities (MSCA).

Results.?Mortality was significantly higher in newborns delivered vaginally (49.3%) than those delivered by c-section (23.1%). Newborns delivered vaginally had a higher incidence of retinopathy and peri-intraventricular hemorrhage (P-IVH). Children who died had lower gestational age at birth and lower birth weight. After multivariate analysis only birth weight, gestational age at birth and P-IVH were independently associated to mortality. Regarding the long-term evaluation (MSCA), we observed that children born by c-section had lower incidence of abnormal results.

Conclusions.?The mode of delivery does not affect survival. Cesarean section provides lower morbidity and better prognosis for neurodevelopment long-term outcome in ELBW infants  相似文献   

13.
Objective. Risk factors for cerebral palsy (CP) in premature infants include duration of mechanical ventilation and exposure to postnatal dexamethasone (DEX). Since DEX can reduce the duration of mechanical ventilation, limited DEX exposure could be beneficial.

Methods. This was a retrospective, cohort study of infants of less than 1500 g birth weight surviving to discharge between 1 January 1996 and 30 June 2001 who received postnatal dexamethasone. DEX administration was based only on the need for O2 and/or mechanical ventilation. CP was diagnosed at over 10 months post-conceptional age. Univariate and multivariate analyses were used to determine significant risk factors and the relative contribution of these factors to overall risk of CP.

Results. Of 218 eligible infants 162 were followed-up (74%). The CP rate was 27.3%. Significant risk factors for CP included gestational age, ventilator duration, DEX dose, presence of periventricular leukomalacia (PVL), seizures, diagnosis of retinopathy of prematurity (ROP) and use of vasopressors. By multiple logistic regression, ventilator duration, PVL, grade III/IV intraventricular hemorrhage (IVH) and DEX dose were significantly related to CP. By stepwise multiple regression, grade III/IV IVH and ventilator duration were the strongest risk factors, but DEX dose continued to be a significant risk factor.

Conclusions. The risk of CP was significantly related to the total cumulative dose of DEX. This could be due to a smaller exposure to DEX or to a reduced need for mechanical ventilation.  相似文献   

14.
Abstract

Objective: To assess the impact of household smoking and palivizumab prophylaxis on the risk of respiratory syncytial virus (RSV) hospitalisation in late-preterm (32–35 weeks’ gestational age) infants.

Methods: Familial smoking and other RSV risk factor data from the FLIP, FLIP-2 and IMpact studies and datasets from France, Germany and Italy, together with palivizumab prophylaxis data from the FLIP-2 and IMpact studies, were analysed using cross-correlation and Bayesian meta-analytical modelling employing Markov Chain Monte Carlo sampling.

Results: There were 2.35 times (95% confidence interval [CI] 1.37–4.02) as many hospitalisations amongst infants from smoking compared with those from non-smoking families. Among non-prophylaxed infants, there were 2.53 times (95% CI 1.27–4.94) as many RSV hospitalisations from smoking than from non-smoking families and that excess hospitalisation was reduced to 1.03 times (95% CI 0.38–2.99) amongst prophylaxed infants. Familial smoking correlates significantly (p?<?0.01) with other RSV risk factors: positive correlation with number of school-age siblings, history of family atopy, family wheeze and gestational age; negative correlation with birth weight and breast feeding.

Conclusions: Late-preterm infants from smoking families appear to be at heightened risk for severe RSV infection requiring hospitalisation of which the risk may be reduced with RSV prophylaxis.  相似文献   

15.

Introduction

risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies.

Methods

a systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that reported qualitative research into risk perception in relation to high risk pregnancy. A metasynthesis was developed to describe and interpret the studies.

Findings

the synthesis resulted in the identification of five themes: determinants of risk perception; not seeing it the way others do; normality versus risk; if the infant is ok, I?m ok; managing risk.

Conclusions

this metasynthesis suggests women at high risk during pregnancy use multiple sources of information to determine their risk status. It shows women are aware of the risks posed by their pregnancies but do not perceive risk in the same way as healthcare professionals. They will take steps to ensure the health of themselves and their infants but these may not include following all medical recommendations.  相似文献   

16.

Objective

The aim of the study was to determine whether route of birth affects early neurological outcome in infants with myelomeningocele.

Study design

In a retrospective cohort study, 95 neonates with myelomeningocele evaluated at the Radboud University Nijmegen Medical Centre between 1990 and 2006 were reviewed. The effect of delivery mode on early neurological outcome was assessed as the difference between the functional neurological level of the defect and the X-ray level (ΔFAX).

Results

Early neurological outcome was better in the vaginally delivered infants (ΔFAX 0.96 ± 2.1) than in those delivered by cesarean section (ΔFAX 0.20 ± 2.5). After correction for confounders, multiple regression analysis demonstrated that vaginal delivery was associated with significantly better early neurological outcome as compared to cesarean section (β = 1.21; 95% CI 0.16; 2.27; p = 0.03) for infants in vertex and breech position combined. Subgroup analysis revealed a non-significant trend towards better outcome after vaginal delivery that was more pronounced in infants in breech position than in vertex position.

Conclusion

In infants with myelomeningocele, born in either vertex or breech position, there is no clinical evidence that early neurological outcome is improved by cesarean section.  相似文献   

17.
Objective: To investigate the association of perinatal risk factors including delivery mode with mortality in very low birthweight (VLBW) in a tertiary hospital setting.

Methods: Medical records of 241 live-born VLBW infants (≤1500?g) were retrospectively reviewed. Details of maternal, obstetrical, perinatal risk factors and their associations with infant mortality were evaluated.

Results: The overall infant mortality rate was 23.2%. Mortality was significantly higher for infants born at ≤27 gestational weeks and with a birthweight of ≤750?g (p?=?0.000 and p?=?0.000, respectively), showing a steep decrease thereafter. On ROC analysis, a cut off of 26.5 weeks was determined for mortality with a sensitivity of 57.1% and a specificity of 90.3% (area under the curve?=?0.792, 95% CI: 0.719–0.866). On multivariate regression analysis, gestational week at birth, birthweight, antenatal steroid treatment and pathologic Doppler ultrasound findings were found as independent risk factors for mortality.

Conclusions: Gestational week at birth, birthweight and antenatal steroid treatment remain the most important perinatal risk factors for infant mortality in VLBW infants. Mode of delivery does not seem to be associated with mortality when adjusted for other perinatal risk factors.  相似文献   


18.
Objective: There is little follow-up data in preterm infants from mothers with systemic lupus erythematosus (SLE). The aim of this study was to determine maternal outcomes and compare neonatal outcomes in preterm and term infants born to mothers with SLE.

Methods: This study is a prospective study in a tertiary medical care center and clinical research center for rheumatoid arthritis. Demographic data, clinical features, laboratory findings, treatment and complications in 77 pregnant SLE patients were prospectively evaluated from 2007 to 2013.

Results: Ninety-two infants (44 males and 48 females including four sets of twins) from 77 mothers with SLE were enrolled. Multivariate logistic analysis indicated that flares were significantly associated with antiphospholipid antibodies of lupus anticoagulant during pregnancy (p?=?0.009) and preterm birth (p?=?0.017). Compared with term infants, preterm infants had significantly higher antinuclear antibodies (ANA) positivity (p?=?0.001) at 12 months of age in multivariate logistic analysis.

Conclusion: Preterm birth is associated with maternal flares and persistent ANA positivity at 12 months of life in infants born to mothers with SLE.  相似文献   

19.
Objective: The aim of this study was to explore the association between serum levels of mannose-binding lectin (MBL) at admission and neurodevelopmental outcomes in a group of Chinese preterm infants, observed prospectively, until 1-year of corrected age (CA).

Methods: All preterm infants used in this study were received from the neonatal intensive care unit (NICU) of our Hospital between 1 January 2012 and 31 August 2013. Serum levels of MBL and clinical data were obtained at the time of admission. The influence of MBL levels on neurological outcome was assessed by logistic regression analysis. Clinical follow-up was performed at 1 year.

Results: The study cohort consisted of 175 neonates at baseline and 105 finished the 1-year follow-up. The mean serum MBL levels at the time of admission were significantly lower in children with adverse neurological outcomes as compared with children with no adverse [0.53 (SD?=?0.09) μg/ml versus 0.80 (SD?=?0.17) μg/ml, respectively; t?=?8.342, p?<?0.0001]. In multivariate analysis, there was an increased risk of adverse neurological outcomes associated with MBL?≤?0.68?μg/ml [odds ratios (OR)?=?12.11, 95% confidence interval (CI): 2.31–30.32; p?<?0.0001] after adjusting for possible factors.

Conclusion: Preterm infants who had low levels of MBL at admission are exposed to an increased risk of adverse neurological outcomes.  相似文献   

20.
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