目的 通过对＜34周呼吸窘迫综合征(RDS)早产儿婴儿期进行系统随访,观察其体格及神经发育的改变。方法 收集在青岛市妇女儿童医院NICU住院且出院后随访至纠正年龄12个月的＜34周RDS早产儿49例(RDS组)、＜34周非RDS早产儿36例(非RDS组),RDS组根据病情严重程度分为轻度RDS组与重度RDS组。以同期在本院儿童保健科健康查体随机抽取的足月儿30例(足月儿组)。纠正年龄0~6个月每个月随访1次,6~12个月每2个月随访1次,每次随访均行体格及神经发育评估,纠正年龄6个月及12个月按贝利婴幼儿发育量表评估发育智商。结果 RDS组出院时、纠正年龄1、2、3、6、12个月宫外生长发育迟缓(EUGR)或生长发育迟缓率分别为71.4%、27.5%、20.5%、20.0%、12.1%、8.3%;RDS组、非RDS组在纠正年龄6个月时MDI、PDI低于足月儿组,20项神经运动检查异常发生率高于足月儿组,纠正年龄12个月时PDI低于足月儿组,差异有统计学意义(P＜0.05);RDS组与非RDS组、轻度RDS组与重度RDS组体格及神经发育比较差异无统计学意义(P＞0.05)。结论 ＜34周RDS早产儿纠正年龄3个月内追赶性生长较明显,其婴儿期体格及神经发育与非RDS早产儿无明显差异,纠正年龄6个月时神经发育落后于足月儿。

Objective To observe the psysical and neurodevelopment in premature infants with respiratory distress syndrome (RDS) of gestational age ＜34 weeks through regular follow-up. Methods A total of 49 premature infants with RDS of gestational age ＜34 weeks and 36 premature infants without RDS of gestational age ＜34 weeks who were followed to twelve months were collected from Qingdao Women and Children's Hospital.They were treated as RDS group and non-RDS group.The RDS patients were divided into the mild RDS group and severe RDS group accoding to severity of illness.A total of 30 full term infants who were randomly selected in the department of child health care were recruited and treated as the full term group.They were followed up once a month at corrected age of 0~6 months and once every 2 months at corrected age of 6~12 months.The Bayley Scale of Infant Development was used to determine the intellectual and neurological development deficits. Results The incidence of extrauterine growth retardation (EUGR) and growth restriction of RDS group was 71.4%,27.5%,20.5%,20.0%,12.1%,8.3% at the time of hospital discharge and corrected age of 1,2,3,6,12 months.The MDI,PDI in RDS group and non-RDS group were significantly lower than those in full term group at corrected age of 6 months (P＜0.05).The abnormal incidence of the 20 items neuromotor assessment in RDS group and non-RDS group was significantly higher than that in full term group (P＜0.05).The PDI in RDS group and non-RDS group was significantly lower than that in full term group at corrected age of 12 months (P＜0.05).The difference of the psysical and neurodevelopment were not significant between RDS group and non-RDS group,the mild RDS group and severe RDS group (P＞0.05). Conclusions The catch-up growth of premature infants with RDS of gestational age ＜34 weeks is significantly within corrected age of 3 months.The psysical and neurodevelopment have no significantly difference between RDS and non-RDS pemature infants.The neurodevelopment of premature infants with RDS of gestational age ＜34 weeks at corrected age of 6 months is poorer than full term infants.