目的 分析早产儿神经心理发育规律,为采取针对性的早期干预提供依据。方法 选取2016年3月—2019年10月在西安市第四医院儿保科就诊并建立专案管理的,符合入组条件的326例早产儿(其中高危早产儿123例,低危早产儿203例)作为观察组,同期随机抽取206例足月儿作为对照组,并在其(纠正)6月龄、12月龄、24月龄采用Gesell对其神经心理发育水平进行评价,对评价结果采用χ2检验进行分析。结果 1)纠正6月龄、12月龄和24月龄时高危早产儿、低危早产儿和足月儿三组之间Gesell各能区迟缓率比较差异存在统计学意义(χ2=13.247、26.600、10.652、15.587、12.920、18.475、30.471、19.339、51.203、6.999、11.601、15.888、7.506、13.564、7.696,P＜0.05);2)同组儿童在纠正6月龄、12月龄和24月龄时Gesell结果比较,三组儿童在大运动、精细运动、语言三个能区差异均有统计学意义(χ2=42.287、17.416、16.492、29.209、14.267、19.768、17.679、39.345、11.448、P＜0.05)。结论 早产儿神经心理发育落后于足月儿,高危早产儿尤为明显,且各能区发育存在不均衡性,正确认识早产儿神经心理发育规律,对实施早期干预有重要意义。
Abstract
Objective To explore the neuropsychological development of preterm infants, so as to provide basis for targeted early intervention. Methods A total of 326 premature infants (including 123 high-risk premature infants and 203 low-risk premature infants) who established project management in Children′s Health Center of Xi′an Fourth Hospital from March 2016 to October 2019 were enrolled in this study, and meanwhile 206 full-term infants were randomly selected as control group. The neuropsychological development level was evaluated by Gesell Developmental Scales (GDS) at the corrected age of 6, 12 and 24 months old. The results of the evaluation were analyzed by Chi-square test. Results 1) There were significant differences on the development delay rate of five dimensions in GDS among high-risk preterm infants, low-risk preterm infants and term infants at the corrected age of 6, 12 and 24 months old(χ2=13.247, 26.600, 10.652, 15.587, 12.920, 18.475, 30.471, 19.339, 51.203, 6.999, 11.601, 15.888, 7.506, 13.564, 7.696,P<0.05). 2) There were significant differences on gross motor, fine motor and language development in the same group of children at the corrected age of 6, 12 and 24 months old (χ2=42.287,17.416,16.492,29.209,14.267,19.768, 17.679,39.345,11.448, P<0.05). Conclusion The neuropsychological development of preterm infants, especially in high-risk preterm infants, lags behind that of full-term infants. And there are imbalances in the development dimensions. Correct understanding of the neuropsychological development of premature infants is of great significance for the implementation of early intervention.
关键词
高危早产儿 /
低危早产儿 /
神经心理发育
Key words
high-risk premature infants /
low-risk premature infants /
neuropsychological development
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基金
陕西省科技厅资助项目(2018SF-081);西安市科技局资助项目[201805098YX6SF32(8)]
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