目的 探讨家庭亲子训练对早产儿生长和神经心理发育的影响,为丰富早产儿早期干预具体实施方法提供线索。方法 选取2022年10月—2023年5月在昆山市妇幼保健院早产儿门诊就诊的87例矫正月龄为0～3月龄的晚期早产儿为研究对象,根据随机数字表法分为两组,对照组48例实施常规跟踪随访,干预组39例在常规跟踪随访的基础上定期参加家庭亲子训练课程。比较两组早产儿矫正3月龄时神经运动发育情况、矫正6月龄时身高、体重、头围、神经心理发育情况以及家庭养育环境。结果 矫正6月龄时,干预组儿童与对照组儿童的体格发育情况差异无统计学意义(P＞0.05)。干预组儿童的Griffiths量表总量表得分(DQ)显著高于对照组儿童,差异有统计学意义(t=3.632, P=0.001)。其中各领域裸分也均高于对照组儿童,但差异无统计学意义(P＞0.05)。干预组儿童的家庭养育问卷各维度及总得分均高于对照组儿童,但仅人际互动/喂养维度得分差异具有统计学意义(t=3.516, P=0.001)。结论 家庭亲子训练不仅能促进晚期早产儿的运动、语言、认知等方面的全面发展,同时能有效改善儿童家庭养育环境,提高家长的养育照护能力,从而更好地促进早产儿的早期健康发展。
Abstract
Objective To explore the effects of family-based parent-child training on the growth and neuropsychological development of premature infants, in order to provide clues for enriching the specific implementation methods of early intervention for premature infants. Methods A total of 87 late-preterm infants aged 0 - 3 months corrected age, who visited the outpatient department of premature infants at Kunshan Institute of Maternal and Child Health Care from October 2022 to May 2023, were selected as study subjects, and were divided into two groups based on the random number table method. The control group (n=48) received routine follow-up, while the intervention group (n=39) participated in regular family-based parent-infant training courses in addition to routine follow-up. The neuromotor development at 3 months corrected age, height, weight, head circumference, and neuropsychological development at 6 months corrected age, as well as the family rearing environment, were compared between the two groups. Results At 6 months corrected age, there was no statistically significant difference in physical development between the intervention group and the control group (P>0.05).The total developmental quotient (DQ) score of Griffiths Scale in the intervention group was significantly higher than that of the control group(t=3.632, P=0.001). Although the raw scores in all domains of the Griffiths Scale were also higher in the intervention group than in the control group, the differences were not statistically significant (P>0.05). The scores of all dimensions and the total score of the family rearing questionnaire were higher in the intervention group than in the control group, but only the difference in the interpersonal interaction/feeding dimension score was statistically significant (t=3.516, P=0.001). Conclusion Family-based parent-child training can not only promote the comprehensive development of late-preterm infants in terms of motor skills, language, and cognition, but also effectively improve the family rearing environment and enhance parental caregiving abilities, thereby better promoting the early healthy development of premature infants.
关键词
晚期早产儿 /
早期干预 /
家庭养育环境 /
神经心理发育
Key words
late-preterm infants /
early intervention /
family rearing environment /
neuropsychological development
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参考文献
[1] 陈雪亭,沈理笑.早产儿精神和体格发育的影响因素及早期干预[J].中国儿童保健杂志,2019,27(12):1324-1326,1338.
Chen XT, Shen LX. Factors influencing the mental and physical development of premature infants and early intervention[J]. Chin J Child Health Care, 2019,27 (12): 1324-1326,1338.(in Chinese)
[2] Johnson S,Evans TA,Draper ES,et al. Neurodevelopmental outcomes following late and moderate prematurity : A population-based cohort study[J].Arch Dis Child Fetal Neonatal Ed,2015,100(4):301-308.
[3] Di GC,Cabero RL,Facchinett F,et al. Preterm labor and birth management: Recommendations from the European Association of Perinatal Medicine[J].J Matern Fetal Neonatal Med,2017,30(17):2011-2030.
[4] 付馨.早期持续家庭康复干预对早产儿智能发育的影响[J].智慧健康,2022,8(33):18-23.
Fu X. The impact of early continuous family rehabilitation intervention on the intellectual development of premature infants[J]. Smart Health, 2022, 8 (33): 18-23.(in Chinese)
[5] Wertlieb D.Nurturing care framework for inclusive early childhood development:Opportunities and challenges[J].Dev Med Child Neurol,2019,61(11):1275-1280.
[6] 谢生勇,陈少华,张爱娟.早期综合干预对中晚期早产儿体格发育及神经心理行为的影响研究[J].中国医学创新,2022,19(15):156-159.
Xie SY, Chen SH, Zhang AJ. Study on the impact of early comprehensive intervention on the physical development and neuropsychological behavior of mid to late stage premature infants[J]. Chinese Medical Innovation, 2022, 19 (15): 156-159.(in Chinese)
[7] Tso WWY,Wong VCN,Xia X,et al.The Griffiths Development Scales-Chinese(GDS-C):Across-cultural comparison of developmental trajectories between Chinese and British children[J].Child:Care,Health and Development,2018,44(3):378-383.
[8] 张沂洁,朱燕,陈超.早产儿发生率及变化趋势[J].中华新生儿科杂志,2021,36(4):74-77.
Zhang YJ, Zhu Y, Chen C. The incidence and trend of premature infants[J]. Chin J Neonatol, 2021,36 (4): 74-77.(in Chinese)
[9] 超未成熟儿与超低出生体重儿研究协作组.广东省2013年与2008年至2012年超低出生体重儿的临床救治结局比较[J].中华围产医学杂志,2017,20(5):358-365.
Collaborative Group on the Study of Ultra Immature Infants and Ultra Low Birth Weight Infants. Comparison of clinical treatment outcomes of ultra low birth weight infants in Guangdong Province from 2013 to 2008—2012[J]. Chin J Perinat Med, 2017,20 (5): 358-365.(in Chinese)
[10] 胡文淼,琚玮.早期康复干预治疗早产儿脑损伤疗效观察[J].新乡医学院报,2018,35(12):1107-1110.
Hu WM, Ju W. Observation of the therapeutic effect of early rehabilitation intervention on premature infant brain injury[J]. Xinxiang Medical College Report, 2018,35 (12): 1107-1110.
[11] 亓伟伟,李燕,秦勇.早期科学综合干预对晚期早产儿行为智能、体格发育的影响分析[J].中国实用医药,2022,17(16):39-42.
Qi WW, Li Y, Qin Y. Analysis of the impact of early scientific comprehensive intervention on the behavioral intelligence and physical development of late preterm infants[J]. China Practical Medicine, 2022, 17 (16): 39-42.(in Chinese)
[12] Engle PL, Fernald LC, Alderman H , et al.Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries[J].Lancet (London, England),2011,378(9799):1399-1353.
[13] 刘维民,鲍秀兰,马磊,等.早期干预降低极低出生体重儿脑瘫发生率的临床研究[J].中国儿童保健杂志,2015,23(4):360-363.
Liu WM, Bao XL, Ma L, et al. Clinical study on early intervention to reduce the incidence of cerebral palsy in extremely low birth weight infants[J]. Chin J Child Health Care, 2015, 23 (4): 360-363. (in Chinese)
[14] 冯丽,刘红梅.早期综合干预在早产儿中的应用效果观察[J].中国社区医师,2023,39(22):145-147,150.
Feng L, Liu HM. Observation of the application effect of early comprehensive intervention in premature infants[J]. Chinese Community Physician, 2023,39 (22): 145-147,150.(in Chinese)
[15] 张悦,邵洁,吴婕翎.高危儿规范化健康管理专家共识[J].中国儿童保健杂志,2023,31(6):581-585,622.
Zhang Y, Shao J, Wu JL. Expertconsensus on standardized health management of high risk infants[J]. Chin J Child Health Care, 2023,31 (6): 581-585,622.(in Chinese)
[16] 吴金花,倪志红,郭宏卿,等.家庭支持干预改善早产儿家庭功能的效果研究[J].中国护理管理,2023,23(8):1163-1169.
Wu JH, Ni ZH, Guo HQ, et al. Study on the effect of family support intervention on improving family function in premature infants[J]. China Nursing Management, 2023,23 (8): 1163-1169.(in Chinese)
[17] Wertlieb D. Nurturing care framework for inclusive early childhood development: Opportunities and challenges[J]. Dev Med Child Neurol, 2019,61(11):1275-1280.
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