早期干预对早产儿早期认知发展的影响研究

Effects of early intervention on early cognitive development in preterm infants

【目的】评价早期干预对早产儿早期神经心理和视觉系统发育的影响,为开展系统的早产儿早期干预提供临床依据。【方法】对干预组早产儿进行定期随访并实施早期干预;于矫正6月龄时对随访≥3次的干预组早产儿、常规随访的未干预组早产儿进行贝莉婴儿发育量表-II(BSID-II)和闪光视觉诱发电位(flash visual evoked potentials,FVEP)测试。【结果】两组早产儿BSID-II测试结果显示,干预组的MDI值、PDI值比未干预组早产儿分别高出9.12分和6.35分,差异有显著的统计学意义;两组早产儿FVEP测试显示:干预组FVEP的P1波潜伏期较未干预组早产儿缩短,差异有统计学意义(P<0.05),N1波、N2波潜伏期和N1P1振幅两组间差异无统计学意义。【结论】有效的早期干预可以促进早产儿早期认知功能和视觉系统的发育;将BSID-II和FVEP相结合的评价,能从认知行为表达和脑电生理两方面更客观而全面地评价早产儿的发育状态;有待于进一步探索早期干预实施对儿童认知发展的远期影响。

【Objective】 To evaluate the effects of early intervention on neurodevelopment and visual system in preterm infant at six months old. 【Methods】 The interventional group infants were followed up regularly and received early intervention monthly;All infants（30 in the interventional group and 22 in the conventional care group） were assessed by using the Bayley Scales of Infant Development-II（BSID-II） and flash visual evoked potentials（FVEP） at six months of corrected age. 【Results】 The mean score of mental development indexes（MDI） of BSID-II in the interventional group and the conventional care group were 98.53±6.96 and 89.41±6.86,respectively;and psychomotor development indexes（PDI） of BSID-II in the interventional group and the conventional care group were 101.8±10.54 and 95.45±7.54,respectively.The mean scores of MDI and PDI in the interventional group were significantly higher than that in the conventional care group.The N1,P1,N2 wave were the major component presented in two groups.The mean latency of P1 in the interventional group and the conventional care group was 118.05±21.85 and 125.70±13.88,respectively.The mean lantency of P1 in the interventional group was significantly shorter than that in the conventional care group（P〈0.05）.There was no significant difference in mean latency of the N1,N2 and the mean amplitude of N1P1 between the two groups. 【Conclusions】 The results show that the effective early intervention can promote neurodevelopment and visual system development of preterm infants.It is needed to further assessment the long-term effects on the child development of the early intervention.