目的 研究早期综合干预对高危儿1岁内运动和认知发育的影响,以期为高危儿出院后的系统化管理提供参考依据。方法 采用分层随机整群抽样法,将2018年1-9月出生并在浦东新区16家社区建册体检的高危儿(早产儿、低出生体重儿)分为对照组和干预组。两组均按《上海市儿童保健工作规范》开展高危儿常规管理,干预组在此基础上增加干预措施。比较两组高危儿运动和认知发育情况。结果 6月龄时干预组动作能(细)高于对照组(t=2.074,P<0.05);12月龄时干预组应物能高于对照组(t=2.353,P<0.05);6~12月龄应人能增长速度干预组高于对照组(t=2.474,P<0.05)。结论 开展医院家庭联合的综合干预对高危儿的早期运动和认知发育具有促进作用。有必要开展进一步随访研究以探讨综合干预对高危儿远期发育的影响。
Abstract
Objective To analyze the effects of early comprehensive intervention on motor and cognitive development of high-risk infants during the first year, so as to provide reference for the systematic management of high-risk infants after discharge. Methods A stratified random cluster sampling method was adopted to select high-risk infants(premature infants and low birth weight infants) born from January to September 2018 from 16 communities in Pudong District.The high-risk infants were registered for physical examination in the corresponding communities, and were divided into the control group and the intervention group.Both groups carried out routine management of high-risk infants according to the “Shanghai Child Health Care Work Standard”, and the intervention group received comprehensive intervention additionally.Motor and cognitive development of the two groups was compared. Results The fine motor development of the intervention group was higher than that of the control group at the aged of 6 months old(t=2.074, P<0.05).The cognition development of the intervention group was higher than that of the control group at 12 months(t=2.353, P<0.05).The increase velocity of the social-skills development in the intervention group was higher than that in the control group(t=2.474, P<0.05). Conclusions The early comprehensive intervention integrated hospital and home can facilitate the motor and cognitive development of high-risk infants.Further follow-up studies are warranted to explore the long-term effects of comprehensive intervention on development.
关键词
高危儿 /
综合干预 /
运动发育 /
认知发育
Key words
high-risk infants /
comprehensive intervention /
motor development /
cognitive development
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参考文献
[1] 刘湘云,陈荣华,赵正言.儿童保健学[M].4版.南京: 江苏科学技术出版社,2011:110.
[2] Hutchinson EA, De Luca CR, Doyle LW, et al.School-age outcomes of extremely preterm or extremely low birth weight children [J].Pediatrics,2013,131(4): e1053-e1061.
[3] Arpi E, Ferrari F.Preterm birth and behaviour problems in infants and preschool-age children: a review of the recent literature[J].Dev Med Child Neurol,2013,55(9): 788-796.
[4] 邹小兵, 李咏梅.儿童发育迟缓及发育障碍的早期干预和管理[J].中国实用儿科杂志, 2016,31(10):756-760.
[5] Hadders-Algra M, Boxum AG, Hielkema T, et al.Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review[J].Dev Med Child Neurol,2017,59(3):246-258.
[6] 袁欣, 郝素媛, 韩炳娟, 等.早期早产儿和/或极低出生体重儿出院后随访及早期干预的临床研究[J].中华围产医学杂志, 2015, 4(10):296-299.
[7] Mills IS, Doyle LW, Cheong JL, et al.Rates of early intervention services in children born extremely preterm/extremely low birth weight [J].J Paediatr Child Health,2018,54(1):74-79.
[8] 刘利蕊, 武彦秋, 刘霞, 等.神经发育早期干预在早产儿纵向发育中的应用效果[J].中国儿童保健杂志, 2019,27(4):414-417.
[9] 熊家玲, 刘宇, 喻琴.早期综合干预对早产儿生长发育的影响[J].中国妇幼健康研究, 2016, 27(9):1035-1037.
[10] 李洁, 姜艳蕊, 王超霞, 等.婴幼儿认知发育的相关影响因素[J].中国儿童保健杂志, 2014,22(3):239-241.
[11] Saigal S, Day KL, Van Lieshout RJ, et al.Health, wealth, social integration, and sexuality of extremely low-birth-weight prematurely born adults in the fourth decade of life[J].JAMA Pediatr,2016,170(7):678-686.
[12] 季丽, 蒋妍.高危儿系统早期干预管理临床效果分析[J].中国妇幼卫生杂志, 2018, 9(5):37-39.
[13] 李倩, 张星贺, 宋咏丽, 等.小儿推拿干预早产儿神经心理发育的系统评价[J].陕西中医, 2019,40(7):972-975,984.
[14] Bann CM, Wallander JL, Do B, et al.Home-based early intervention and the influence of family resources on cognitive development[J].Pediatrics,2016,137(4).pii:e20153766.
基金
上海市浦东新区卫生和计划生育委员会优秀青年医学人才培养计划(PWRg2017-23)
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