中国儿童保健杂志 ›› 2018, Vol. 26 ›› Issue (3): 294-297.DOI: 10.11852/zgetbjzz2018-26-03-18

• 临床研究与分析 • 上一篇    下一篇

多学科合作的早产儿系统管理对新生儿重症监护室出院早产儿神经精神发育结局的影响

田园1, 张宇鸣2, 陈菲3, 冯金彩4, 章春草1, 胡湘英5, 于广军3   

  1. 上海市儿童医院1 健康管理部 2 新生儿科 3 儿童保健科 4 康复科,上海 200040
    5 上海市静安区妇幼保健所,上海 200042
  • 收稿日期:2017-08-25 发布日期:2018-03-10 出版日期:2018-03-10
  • 通讯作者: 于广军,E-mail:yugj1688@shchildren.com.cn
  • 作者简介:田园(1981-),女,新疆人,主管医师,博士学位,主要研究方向为高危儿管理、高危儿早期干预。
  • 基金资助:
    上海市第四轮加强公共卫生体系建设三年行动计划(2015-2017)多学科合作的高危儿综合管理(GWIV-19);上海申康医院发展中心社区适宜技术项目资助(SHDC12014203);上海市科学技术委员会科技成果转化和产业化项目(16511104903)

Impact of a multidisciplinary team systematic management on the neurodevelopmental outcomes of neonatal intensive care unit preterm infants

TIAN Yuan1, ZHANG Yu-ming2, CHEN Fei3, FENG Jin-cai4, ZHANG Chun-cao1, HU Xiang-ying5, YU Guang-jun3   

  1. 1 Department of Child Health Management
    2 Department of Neonatology
    3 Department of Child Health Care
    4 Department of Child Rehabilitation,Children's Hospital of Shanghai,Shanghai 200040,China
    5 Jingan Maternal and Child Health Care Hospital,Shanghai 200042,China
  • Received:2017-08-25 Online:2018-03-10 Published:2018-03-10
  • Contact: YU Guang-jun,E-mail:yugj1688@shchildren.com.cn

摘要: 目的 分析多学科合作系统管理和早期综合干预对新生儿重症监护室(NICU)出院早产儿近期神经发育结局的影响。方法 回顾分析和比较在上海市儿童医院早产儿整合门诊接受随访的早产儿,根据管理模式分为非系统管理且无干预阶段,以及多学科合作开展系统管理阶段,比较两阶段NICU出院早产儿发育迟缓发生率;通过对照研究评价多学科合作的系统管理对NICU早产儿近期神经发育结局的影响。结果 1999年1月-2016年6月累计登记随访NICU出院早产儿997例,两阶段中早产儿随访至校正12月龄段时,系统管理下的早产儿各能区发育迟缓发生率较低(P<0.05)。对照研究表明,NICU出院早产儿接受系统管理后,校正18月龄发育商可达平均水平。结论 多学科合作开展系统的随访管理,能改善NICU出院早产儿近期神经精神发育结局。

关键词: 多学科合作, 新生儿重症监护室, 早产儿, 系统管理

Abstract: Objective To analyze the impact of systematically follow-up and early intervention on the recent neurodevelopmental outcomes of neonatal intensive care unit (NICU) preterm infants in a multidisciplinary team (MDT) framework. Methods Retrospective analysis and intervention-controlled study were conducted.The developmental abnormalities ratio of the recorded preterm infants discharged from Shanghai Children's Hospital were analyzed and the outcomes were compared with those under systematically follow-up and early intervention The impact of MDT systematically follow-up and early intervention on the neurodevelopmental outcomes of NICU preterm infants were evaluated through a prospective intervention-controlled study. Results Totally 997 infants discharged from NICU were recorded and analyzed from Jan. 1999 to Jun.2016 Infants with systematically follow-up and early intervention had lower developmental abnormalities ratio (P<0.05).Intervention-controlled study further showed that infants in intervention group could be developed to the average scores. Conclusion Preterm infants discharged from NICU need systematically follow-up and effectively early intervention by specialist in a MDT framework to make sure a better outcome.

Key words: multidisciplinary cooperation, neonatal intensive care unit, preterm infants, systematic management

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