定期发育监测及早期干预对婴儿智力发育效果评价

Evaluation of the Effects of Regular Development Monitoring and Early Intervention on Infant Intelligence Development

目的 评价定期发育监测及早期干预对正常儿及高危儿智能发育的效果。方法 2 0 0 2年 3～ 10月在本院妇产科出生的新生儿参加定期系统化管理的婴儿 1812例 ,其中正常儿 172 0例 ,随机分为早期干预组 (930例 ) ,对照组 (790例 ) ;高危儿 92例中早产儿 37例 ,缺氧缺血性脑病 5 5例 ,根据原发病不同分为早产儿组和缺氧缺血性脑病(HIE)组 ,各组再根据有无系统干预分为干预组、非干预组。在干预组根据监测小儿智能发育状况进行干预训练指导。正常儿两组 3、 6、 9、 12个月进行智能发育评估及精神发育单项评估 ;高危儿 6、 12个月时 ,对两组小儿进行发育落后情况及智能发育诊断量表测试。结果 正常儿 3个月、 6个月干预组智能发育筛查的可疑率与对照组间差别有显著性意义 (Ρ <0 0 1) ;干预组在大运动、精细动作、语言能力及社会适应能力方面单项指标平均月龄较对照组差别均有显著性意义 (Ρ <0 0 1) ;高危早产儿组及HIE组的干预组婴儿的中枢神经协调障碍、言语障碍及脑性瘫痪的发生与未干预组间差别有显著性意义 (Ρ <0 0 5 )。两组高危儿智能发育检查 :早产儿组及HIE组的干预组在粗大动作、精细动作及言语能方面与未干预组间差别有显著性意义 (Ρ <0 0 1) ,而在社交能力及认知能力方面差别无显著性?

Objective To evaluate the effects of regular development monitoring and early intervention on infant intelligence development in the normal and high risk infants.Methods 1812 infants born in the hospital obstetrics and gynecology from 2002.3 to 2002.10 were systematically cared and observed by regular determination.Among 1812 cases,1720 were normal infants divided into two groups with early intervention group (930 cases) and control group (790 cases).92 high-risk infants included 37 premature infants and 55 hypoxic isochemic encephalopathy (HIE).According to the original disease,92 infants were divided into premature infants group and HIE group.According to system intervention or not,each group was divided into early intervention and no intervention group.The training of intelligence was taken in the early intervention group according to the determination of intelligent development.The determination of intelligent and psychiatric development was taken in 3,6,9 and 12 months in normal infant groups and in 3 and 6 months in high risk infant groups.Results The difference of the suspicious case of hypothermia between early intervention group of normal infants and control group has obvious significance (P<0.001).The difference between the early intervention group and control group in average months for development of rough and fine motion,linguistic function and social adaptation has obvious significance (P<0.01).The incidence of central nervous in coordination,aphasic and encephalopatnic paralysis in early intervention group of high risk infant has significant difference when compared with no intervention group (P<0.05).The determination of intelligent development in premature group and HIE group of high risk infants demonstrated that the difference between the early intervention group and no intervention has obvious significance in the rough and fine motion and linguistic (P<0.01).The difference between early intervention and no intervention group of high risk infants has no significance in the sociality and gnosia (P>0.05).Conclusion Regular determination of systematic development and early intervention can improve the intelligent development and decrease the incidence of intelligent retardation in infants.