超早期综合干预对晚期早产儿早期智能及体格发育的影响

Effect of ultra-early comprehensive intervention on early intellectual and physical development of late premature infants

目的探索超早期综合干预对晚期早产儿早期智能及体格发育的影响,为临床有效干预提供参考依据。方法选取2017年4月—2018年4月在上海市长宁区妇幼保健院出生并在早产儿门诊随访管理的116例全身运动(general movements,GMs)质量评估中扭动运动阶段评估结果为单调性GMs的晚期早产儿,使用随机数字表法将其分为干预组(56例)和对照组(60例)。干预组除正常早产儿门诊随访外,在矫正胎龄3月龄内给予超早期综合干预三项(可视音乐治疗、纽安垫感觉统合训练、中医推拿)1个疗程,对照组予以正常早产儿门诊随访。在矫正胎龄6月龄时采用Gesell发育诊断量表对2组早产儿进行智能评估并测量其体重、身长和头围等生长指标,比较2组早产儿智能及体格发育指标。结果在矫正胎龄6月龄时,干预组在粗动作、应物能、应人能3个能区得分分别为(99.64±8.50)分、(94.93±7.46)分、(96.59±6.34)分,明显高于对照组的(94.42±8.29)分、(89.67±10.92)分、(91.65±7.44)分,差异具有统计学意义(均P<0.05);在精细动作、言语能2个能区,干预组的得分为(87.66±12.01)分和(91.41±8.72)分,对照组的得分为(83.97±9.42)分和(90.53±11.46)分,2组早产儿之间比较差异无统计学意义(均P>0.05);干预组和对照组早产儿矫正胎龄6月龄时体重、身长、头围的发育比较差异无统计学意义(均P>0.05)。结论超早期综合干预可促进晚期早产儿早期智能的发育,但对早期体格发育的影响不明显。

Objective To study the effect of ultra-early comprehensive intervention on early intellectual and physical development of late premature infants,and to provide reference for effective clinical intervention.Methods A total of 116 late preterm infants born in Changning Maternal and Infant Health Care Hospital of Shanghai from April 2017 to April 2018 and managed in the follow-up clinic of premature infants,which had poor repertoire GMs were randomly divided into intervention group(56 cases)and control group(60 cases)used by random number table method.In addition to the normal follow-up in Preterm Infant Clinic,the intervention group was given three comprehensive interventions(visual music therapy,sensory integration training and traditional Chinese massage)within 3 months of corrected gestational age for one course of treatment.The Gesell Developmental Scale(GDS)was used for late preterm infants at the corrected age of 6 months,and their weight,length and head circumference were simultaneously measured,and to compare the intellectual and physical development of the two groups.Results The gross motor,adaptability and social competence scores of the intervention group at the corrected age of 6 months were(99.64±8.50)points,(94.93±7.46)points and(96.59±6.34)points,which were significantly higher than(94.42±8.29)points,(89.67±10.92)points and(91.65±7.44)points of the control group,with statistically significant differences(all P<0.05).In fine motor and language areas,the scores of intervention group were(87.66±12.01)points and(91.41±8.72)points,while the control group were(83.97±9.42)points and(90.53±11.46)points,there was no significant difference between the two groups(all P>0.05).There was also no significant difference in weight,length and head circumference between the intervention group and the control group when correcting gestational age of 6 months(all P>0.05).Conclusion Ultra-early comprehensive intervention can promote early intellectual development of late preterm infants,but it has no obvious effect on early physical development.