【目的】 探究学龄前期低危晚期早产儿认知发育状态和视觉-运动整合能力,比较其与同龄正常儿童的差异,为实施针对性干预方案提供依据。 【方法】 以上海-Wechsler学前及初学儿童智能测验量表和中国修订Beery视觉-运动整合测验工具评估69例学龄前期儿童(其中早产儿31例,正常足月儿38例)的智能和视觉运动整合能力。 【结果】 早产儿组的语言、操作和总智能分均值为:97±21、107±15、102±18;正常足月儿组依次为112±15、128±12、122±11。两组儿童智能虽处于平均水平,但早产儿组的认知能力远低于正常足月儿组(t=5.53,P<0.01),尤其在高级语言能力和操作能区上表现的更为薄弱。早产儿和正常足月儿组的视觉-运动整合能力均值分别为:88±16、109±18,两组间差异有高度统计学意义(t=4.93,P<0.01),且其差距较操作能区的差异还要大,达到了24%。将视觉-运动整合分值与总智商做相关分析发现,两者存在着正相关(r=0.6,P<0.05)。 【结论】 低危晚期学龄前期早产儿,虽具备正常认知能力,但仍较正常足月儿落后,尤其在高级语言功能和视觉感知运动方面,差距甚大。应在学龄前期对这类儿童加强随访评估,实施针对性干预措施。

【Objective】 To investigate low-risk late preterm preschoolers' cognitive and visual-motor integration performance and compare them to normal children. 【Methods】 Participants were 31 late preterm and 38 normal children who were 4 to 6 years old and were free from major disability.They were evaluated using the Chinese population adaptation of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and Berry visual-motor integration kit (VMI). 【Results】 The mean scores of VIQ, PIQ and FIQ in preterm and full-term group were 97±21, 107±15, 102±18; 112±15, 128±12, 122±11 respectively. Compared with normal children,the preterm preschoolers had significantly lower level in the tests of verbal, performance and overall intelligence quotients(P<0.01), particularly in higher-level verbal and performance function, although the levels were within the average range. The mean scores of VMI in preterm and full-term preschoolers were 88±16 and 109±18. The poor ability of VMI in preterm children had significantly 24% difference with the control group, even worse than the performance intelligence quotients. Furthermore, the VMI was positively correlated with the full intelligence quotients (r=0.6,P<0.05). 【Conclusions】 Low-risk late preterm preschoolers with average cognition capability still have poorer cognitive ability compared with the normal children. Moreover, they are at risk of defect in visual-spatial perception and higher-functional verbal capability. Detection specific visual perceptual and verbal dysfunction before school age, even in children with a low risk of mental and neurological problems could provide specific rehabilitative strategies to prevent learning and/or behavioral problems.