目的 应用闪光视觉诱发电位(FVEP)、贝莉婴儿发育量表-Ⅱ(BSID-Ⅱ)方法评估早期干预对晚期早产儿(LPIs)早期神经心理和视觉发育的影响,为有效开展系统的早产儿早期干预及评估方案提供临床依据。方法 对LPIs干预组(A组)、LPIs对照组(B组)、足月儿(FTIs)对照组(C组)进行定期随访,并对A组实施早期干预;于矫正月龄3+0.7、6±0.7、12±0.7时对三组随访婴儿进行FVEP、BSID-Ⅱ评估。结果 1)FVEP 评估①A组3、6、12月龄P1均值为165.59、131.91、102.20。②A组随月龄增大P1均值逐渐接近C组,12月龄C、A两组P1均值差异无统计学意义(P>0.05),说明LPIs经干预后脑视觉神经发育速度加快。2)BSID-Ⅱ评估①A组对3、6、12月龄PDI均值为89.6、94.5、102.8;MDI均值为88.9、95.3、101.4;C组PDI 均值为103.2、103.7、108.2;MDI均值为100.7、104.3、106.1。三组间各月龄C组PDI、MDI均值最大。②A组PDI、MDI均值随月龄增大逐渐接近C组,但12月龄C、A两组PDI、MDI均值差异有统计学意义(P<0.05),说明LPIs经干预后脑精神运动发育速度加快,但仍落后于足月儿。结论 LPIs的视觉、认知及运动发育水平虽正常但落后FTIs,早期干预可以有效提高其该发育水平。婴儿1岁以内视觉发育呈非匀速水平,对LPIs早期干预,矫正6月龄后见追赶式发育。LPIs干预后6月龄综合发育水平优于单纯的视觉发育水平。建议两种评估方法结合使用,起到优势互补作用。
Abstract
Objective To assess the impact of early intervention on late preterm infants' (LPIs) early neuropsychological and visual system development,to provide clinical evidence for early intervention programs in preterm children. Methods LPIs in the intervention group(GA),LPIs in the not intervention group(GB),full-term infants (FTIs) in the control group (GC)were regular followed-up,GA were implemented of early intervention; Three groups of infants whose corrected 3 + 0.7,6±0.7,12±0.7 months of age,were assessed flashvisual evoked potential ( FVEP),Bayley Scales of Infant Development Ⅱ (BSID-Ⅱ). Results 1)FVEP assessment in the three groups showed that the mean P1 latency of GA were 165.59,131.91,102.20 at corrected ages of 3,6 and 12 months respectively;P1 mean of GA increased with age increaseing.Between GC and GA,P1 mean showed no significant difference (P>0.05) at 12 months age,description after the intervention of LPIs its visual neurodevelopment speed.2)BSID-Ⅱ assessment in the three groups showed that the mean PDI scores of GA were 89.6,94.5,102.8; the mean MDI scores of LPIs were 88.9,95.3,101.4 at corrected ages of 3,6 and 12 months respectively;the mean PDI scores of GC were 103.2,103.7,108.2; the mean MDI scores of FTIs were 100.7,104.3,106.1 at 3,6 and 12 months respectively.PDI,MDI mean of GC were maximum among three groups.MDI,PDI means of GA increased with age,P1 mean showed no significant difference (P<0.05) between GC and GA,indicating that LPIs brain psychomotor development speed after the intervention,but lower than FTIs. Conclusions Although visual development,cognitive and motor development levels of LPIs were normal,but lower than FTIs,early interventions to those can improve the cognitive and sports development.Visual development of infants younger than 1 year old is in a non-uniform level to see the development of catch-up after 6 months of age corrected.After 6 months of intervention LPIs comprehensive developmental level is higher than purely visual level of development.Proposal evaluation methods will be used in combination and can play a complementary role.
关键词
晚期早产儿 /
足月儿 /
早期干预
Key words
late-preterm infants /
full-term infants /
early intervention
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参考文献
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基金
上海浦东新区科委创新基金项目(PKJ2012-Y33)
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