高危儿管理和早期干预网络的建立及效果评定

Establishment and effectiveness assessment of high-risk infant management and early intervention network

目的建立高危儿管理和早期干预网络，降低高危儿智力低下、营养不良的发生率。方法新生儿出院前家长在辖区保健机构办理儿童保健手册时，医生依据分娩记录对新生儿进行高危因素筛查，筛查出的高危儿依托儿童保健系统管理网络及时上报并根据高危因素的不同进行分层、分级管理和早期干预，参照鲍氏早期教育资料进行干预，并辅以科学喂养相关知识的指导。结果通过对设立的高危儿干预组、高危儿未干预组和健康对照组婴儿1岁时进行测评的结果显示：干预组的儿童智能发育指数为90．62±9．18，明显高于未干预组的发育平均指数83．43±15．95（t=7．190，P〈0．01），与健康对照组的91．04±13．11基本接近（t=0．419，P〉0．05）；未干预组的儿童中重度营养不良的发生率（18．37％）明显高于干预组（4．00％）（，=8．652，P〈0．05）。结论通过健全的高危儿管理网络对高危儿进行管理和早期干预可以提高儿童智能发育指数和体格发育水平，减少智力残疾和中、重度营养不良的发生。

Objective To establish management and early intervention networks of high-risk infants（ HRIs）, so as to decrease incidence rates of mental retardation and malnutrition in HRIs. Methods The neonates were screened for high risk factors according to their birth records when the neonates＇ parents transacted＇ children＇s health handbook＇ for them in health institution in the administrative area before discharge. The identified high-risk infants were reported timely to the top institution through systematic management network of children＇ s health and were managed stratitiedly and fractionally and received early intervention based on Bao＇ s early education materials combined with instruction of scentific feeding-related knowledge. Other HRIs and normal infants were not intervened. Results At full one year of age, the intelligence development index of HRI in the intervention group was significantly higher than that of HRI in the unintervened group by CDCC （90.62 ± 9.18 vs 83.43 ±15.95, t = 7. 190, P 〈 0.01 ） but was close to that in the control group （91.04 ± 13.11 ） （ t = 0.419, P 〉 0.05 ）. The incidence rate of morderate and severe malnutrition in unintervened group was significantly higher than that in the intervention group（ 18.37% vs 4.00%, X2 = 8. 652, P 〈 0.05 ）. Conclusion Management and early intervention for HRIs through a perfect network system can increase their intelligence development index and physical development level of the infants and decrease incidence rates of mental disabilities and moderate and severe malnutrition.