早期干预随访对高危儿发育影响的临床研究

目的研究早期干预随访在高危儿发育的临床意义。方法 2013年5月至2015年5月深圳市龙华新区人民医院新生儿科重症监护室收治住院的高危新生儿106例及门诊58例,106例高危儿出生即接受干预和随访设为新生儿干预组,58例高危儿干预时间在出生1个月后设为婴儿干预组,120例健康新生儿设为对照组,定期随访、评估。观察3组在出生后6个月、12个月的体格发育情况;新生儿干预组与对照组出生1周以及4周进行新生儿神经行为测定比较;各组大运动发育、原始反射消失以及姿势反射建立时间。结果出生后6个月新生儿干预组、婴儿干预组身长、体质量、头围均低于对照组,差异有统计学意义(P0.05);出生后12个月3组身长、体质量、头围比较差异均无统计学意义(P0.05)。新生儿干预组出生1周新生儿神经行为评分低于对照组,差异有统计学意义(P0.05),出生4周后两组新生儿神经行为评分比较差异无统计学意义(P0.05)。新生儿干预组、对照组大运动发育中坐、爬、姿势反射建立时间比较差异无统计学意义(P0.05),均优于婴儿干预组,差异有统计学意义(P0.05);大运动发育中抬头、翻身以及原始反射消失时间3组组间比较差异均有统计学意义(P0.05)。结论早期干预、定期随访在高危儿康复发育过程有重要的临床意义。

Study on the effect of early intervention and follow-up on the development of high risk infants

Objective To study the clinical significance of early intervention and follow-up in the de-velopment of high risk infants.Methods Totally 106 cases of high risk infants who accepted the intervention and follow-up immediately after birth were included as neonatal intervention group,58 cases of high risk in-fants who accepted intervention one month after birth were included as infant intervention group,and 120 cases of healthy neonates were included as the control group;regular follow-up and evaluation were per-formed.Observe the physical development at six months and 12 months after birth in the three groups.In the neonatal intervention group and control group,neurological behavior was determined at 1 week and 4 weeks after birth.Observe the gross motor development,primitive reflex disappearance and establishment time of posture reflex.Results At 6 months after the birth the body length,weight and head circumference of neonatal and infant intervention group were lower than the control group with statistical difference(P <0.05);at 12 months after birth the height,weight and head circumference of three groups showed no statis-tical difference(P >0.05);1 week after birth the NBNA score of neonatal intervention group was lower than the control group(P < 0.05);4 weeks after birth the NBNA scores of the two groups had no statistical difference(P >0.05);the establishment time of gross motor development in sitting,crawling and postural reflex of the neonatal intervention group and the control group had no statistical difference(P >0.05),which were better than those of infant intervention group,and the difference was statistically significant(P <0.05);gross motor development in rising,turning over and the disappearance time of primitive reflex in all these groups had statistical difference(P <0.05).Conclusion Early intervention and regular follow-up have important clinical significance in the recovery and development of high risk infants.