早产儿轻度运动发育迟缓的评定与干预模式研究

目的 分析早产儿轻度运动发育迟缓的评定及早期干预模式,为早产儿随访及干预提供新模式。方法 选取2018年3月1日-2019年3月31日在南方医科大学附属小榄医院儿童保健科建卡并常规随访的早产儿100例。研究对象用0～1岁20项神经运动检查(20项)检查,并被分为干预组33例、对照组31例、正常组32例及转诊的早产儿4例。比较干预组与对照组早产儿干预后的Alberta婴儿运动量表(AIMS)得分及12月龄时3组早产儿发育商(DQ)。结果 1)干预后,干预组AIMS得分高于对照组,差异有统计学意义(t=2.06,P＜0.05)。2)干预组、正常组与对照组12月龄时的大运动DQ、言语DQ、社交行为DQ比较,差异有统计学意义(F=9.49、9.02、4.53,P＜0.05)。两两比较结果显示,对照组与正常组、对照组与干预组间的大运动DQ差异均有统计学意义(P＜0.05);干预组与正常组、对照组与正常组间的言语DQ比较,差异均有统计学意义(P＜0.05);对照组与正常组间的社交行为DQ比较,差异有统计学意义(P＜0.05);其余组间两两比较差异无统计学意义(P＞0.05)。3)转诊早产儿4例,无视、听异常婴儿。结论 以20项为随访基础、以AIMS为早期干预指导基础及以Bobath运动疗法为主的早期综合干预模式在轻度运动发育迟缓早产儿随访中具有可行性。

Study on assessment and intervention mode of mild motor developmental retardation in preterm infants

Objective To analyze the assessment and early intervention mode of mild motor developmental delay in preterm infants,in order to provide a new mode for follow-up and intervention of preterm infants. Methods A total of 100 preterm infants with first follow-up card and routine follow-up from March 1st,2018 to March 31st,2019 in the Children′s Health Department of Affiliated Xiaolan Hospital,Southern Medical University were selected in this study,and were examined by 20 neuromotor examinations at 0-1 years (20-items).The preterm infants were divided into intervention group (n=33),control group (n=31) and normal group (n=32),and 4 cases of premature infants were referred.The Alberta Infant Motor Scale (AIMS) scores of the preterm infants in intervention group and control group were compared after intervention and the development quotient (DQ) of the three groups of preterm infants at the age of 12 months were compared. Results 1) After the intervention,AIMS score of the intervention group was significantly higher than that of the control group (t=2.06,P＜0.05).2) The gross motor DQ,verbal DQ,and social behavior DQ at 12 months old among the intervention group,normal group and control group were significantly different (F=9.49,9.02,4.53,P＜0.05).Further analysis showed that the difference on gross motor DQ between control group and normal group,as well as between control group and intervention group were both significant (P＜0.05).Differences on verbal DQ between intervention group and normal group,as well as between control group and normal group were significant (P＜0.05).Moreover,the difference on social behavior DQ between control group and normal group was significant (P＜0.05),but there was no statistically significant difference between the other groups (P＞0.05).3) Four cases of premature infants were referred and there were no infants with visual or hearing abnormalities. Conclusion The early comprehensive intervention mode based on 20 neuromotor examinations for follow-up,AIMS as the guidance for early intervention and the early interventions focused on Bobath therapy is feasible in the follow-up of premature infants with mild motor retardation.