目的 探讨极低出生体重儿在新生儿重症监护病房(NICU)的早期干预对其预后的影响。方法 选择2014年1月-2015年10月在本院NICU住院治疗的81例极低出生体重儿为研究对象,分为两组:家长参与早期干预的为干预组(40例);家长未参与早期干预的为对照组(41例)。干预组在NICU住院期间进行发育支持护理,在出院前一周进行刺激训练、肢体运动训练并教会家长;出院后每周 1次电话随访指导;家长参与科室微信群及早产儿家长学校获取干预指导。对照组按常规治疗护理出院并做随访。评估两组在纠正胎龄44周时的体格发育和全身运动(GMs)。结果 两组在纠正胎龄44周时的体重、身长比较,差异有统计学意义(P＜0.05);头围比较,差异无统计学意义(P>0.05);干预组正常扭动运动共33例,对照组22例,两组差异有统计学意义(P＜0.05);单调扭动运动(PR)干预组为5例,对照组12例,差异有统计学意义(P＜0.05);痉挛同步扭动运动(CS)干预组为2例,对照组7例,差异有统计学意义(P＜0.05)。结论 在NICU住院期间开始早期干预可以改善极低出生体重儿的预后。
Abstract
Objective To investigate the significance of early intervention in very low birth weight infants (VLBWI) treated in neonatal intensive care unit (NICU). Methods The hospital dates of 81 VLBWI from January 2014 to October 2015 were divided into two groups,intervention group (40 cases) and the control group (41 cases).In the intervention group,infants were nursed through NIDCAP and intervened by training of stimulation and physical before their discharge.Their parents learned the intervention measure by the Wechat group and the school about premature.The follow-up were performed by telephone once a week after their discharge.In control group,infants were nursed with the routine intervention and followed up.At 44 weeks gestational age,the indicator of their physical development and GMs were investigated and compared. Results At 44 weeks gestational age,there was no significant difference (P<0.05) in weight and length;No statistically significant was found in head circumference.Comparing the GMs of the two groups,the intervention group had higher occurrence of normal general movements (33 cases vs.22cases).In contrast,the intervention group had lower occurrence of poor repertoire general movements (5 cases vs.12 cases) and cramped-synchronized general movements (2 cases vs.7cases).The difference was statistically significant (P<0.05). Conclusions In NICU,early intervention in VLBWI can improve the prognosis of VLBWI.
关键词
早期干预 /
早产 /
全身运动 /
儿童发育
Key words
early intervention /
preterm /
general movement /
child development
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基金
江苏省妇幼保健资助项目(F201330);南通市科技计划项目(HS149103)
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