早产儿婴儿期神经行为发育随访结果分析

目的:探讨早产儿婴儿期神经行为发育情况,为临床早期干预提供理论依据。方法:2008年4月～2009年3月在烟台毓璜顶医院儿童保健中心接受保健服务的381例早产儿作为研究组,随机抽取同时期在毓璜顶医院儿童保健中心体检的足月儿350例作为对照组,进行前瞻性队列研究。早产儿于纠正胎龄40周、足月儿于出生后2～3天进行NBNA评分;在早产儿纠正年龄/足月儿生后年龄为3、6、9月及1岁时采用首都儿科研究所修订的《0～6岁小儿神经心理发育量表》测查发育商(DQ)。结果:早产儿与足月儿NBNA评分差别有统计学意义(t'=-13.4496,P0.0500)。早产儿组NBNA评分≤35分者22例,与对照组(6例)相比差别有统计学意义(χ2=8.163,P=0.043)。早产儿组在3、6月及1岁时的发育商低于足月儿,早产儿大运动、精细动作、语言落后于足月儿。早产儿组智力低下发生率高于对照组。结论:早产儿的智力发育水平低于足月儿,尤其是大运动、精细动作、语言落后于足月儿。应进行系统的早期干预,促进早产儿潜在能力得到最大程度的发挥。

Analysis on follow - up results of neurobehavioral development of premature infants during infant period

Objective:To explore the status of neurobehavioral development of premature infants during infant period,and provide a scientific basis for early clinical intervention.Methods:381 premature infants receiving health care services from April 2008 to March 2009 were selected as study group,350 full term infants receiving physical examination were selected randomly as control group,prospective cohort study was used in the study.NBNA score was conducted to premature infants (rectified gestational age=40 weeks) and full term infants (2 ～ 3 days old).Developmental quotients in the two groups were detected by neuropsychological development scale of infants aged 0 ～ 6 years old when they were 3,6,9 and 12 months old.Results:There was significant difference in NBNA score between premature infants and full term infants (t'=-13.449 6,P < 0.050 0) ;the numbers of NBNA score≤35 in premature infants group and full term infants group were 22 and 6,there was significant difference (χ2=8.163,P=0.043) ;the developmental quotients at 3,6,9 and 12 months in premature infants group was significantly lower than those in full term infants group,the scores of gross motor,exiguous action and language in premature infants group was significantly lower than those in full term infants group;the incidence of hypophrenia in premature infants group was significantly higher than that in full term infants group.Conclusion:The level of intellectual development of premature infants is lower than that of full term infants,especially gross motor,exiguous action and language;early systematic intervention may promote the exertion of potential ability of premature infants to the utmost extent.