超早期干预对早产儿智能和体格发育的影响

目的 探讨超早期干预对早产儿智能和体格发育的临床效果.方法 选择2005年8月至2008年7月在本院新生儿重症监护病房(NICU)住院的出生时胎龄为30～36孕周的早产儿120例(除外先天畸形和遗传代谢性疾病)为研究对象.按照家长是否自愿让新生儿参加超早期干预模式指导的原则,将其分别纳入干预组(n=60)和对照组(n=60)(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与其签署临床研究知情同意书).对两组早产儿于NICU住院期间在进行常规治疗的同时,当干预组早产儿生命体征稳定后,即给予超早期干预模式治疗,该模式为多感官刺激为主的康复训练,包括强化体操、动作和运动训练干预,而对照组早产儿不接受相应干预.白早产儿出院后,两组均在家中由家长按照本研究制定的早期教育计划对早产儿进行早期教育,均定期接受<盖塞尔量表>智能及体格发育指标评价.干预组则在早期教育基础上,继续按照超早期干预模式对早产儿重点进行强化体操、动作和运动训练干预.结果 干预组早产儿于NICU的平均住院时间(8 d)显著短于对照组(15 d).两组比较,差异有统计学意义(P<0.05).干预组早产儿6个月龄及12个月龄时,平均发育商(DQ)(粗大动作能力、精细动作能力、应物能力、语占能力、应人能力5个能区)均高于对照组,且差异有统计学意义(P<0.05).结论 对早产儿采取超早期干预模式进行干预,可促进早产儿的消化、呼吸等器官功能成熟,缩短住院时间,明显促进早产儿的智能和体格发育.

Influence of Ultra-Early Intervention on the Physical and Intellectual Development of Premature Infants

Objective To explore the influence of ultra-early intervention on intellectual and physical development of premature infants.Methods From August 2005 to July 2008,a total of 120 survived premature infants,born at 30-36 weeks of gestational age,were recruited into neonatal intensive care unit(NICU).All of them had no congenital deformity and hereditary metabolic disease.They were divided into intervention group(n=60) and control group(n=60) according to whether their parents allow their infants to be involved in the ultra-early intervention model or not.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Dazhou Central Hospital.Informed consent was obtained from the parents of each participating neonate.There had no significance difference between two groups among birth weight,gestational age at delivery,gender,delivery mode,Apgar score,complications,maternal age,rates of breast feeding and culture degree of parents(P>0.05).Premature infants in both groups received conventional treatment,and intervention group received ultra-early intervention including rehabilitation training focused on sensory stimulation after their vital signs became stable.Intervention of exercise,activities and motion were performed in rehabilitation training.After the premature infants discharged from NICU,both groups received early education which were performed by the parents according to early education schedule of this study.Besides that,intervention of exercise,activities and motion were performed in intervention group only.Intellectual and physical developmental conditions in two groups were followed up and evaluated regularly by Gesell Developmental Schedules.Results Hospital stay at NICU in intervention group(8 d) was much shorter than that in control group(15 d) with significant difference(P<0.05).There had significant difference of mean value of development quotient(DQ) between two groups when the premature infants were at 6-month-old and 12-month-old(P<0.05).Conclusions Ultra-early intervention can not only promote the maturation of digestive function and respiratory function of premature infants and shorten the hospital stay at NICU,but also significantly promote the intellectual and physical development of premature infants.