医教结合促进高危儿早期发展的临床效果研究

Study on clinical efficacy of early development in high-risk infants by combination of education with medical treatment

目的探索医教结合干预法对高危儿早期发展的效果,促进高危儿早期康复和身心全面发展。方法选取2010年6月-2011年1月在湖北省妇幼保健院儿童保健科高危儿门诊进行随访的1个月的高危儿为研究对象。高危儿医教结合140例,医学干预组142例,健康对照组125例。6、12、24月龄时三组进行智力和运动发育测评,24月龄时进行幼儿情绪社会性评估。结果医教结合组各月龄智力发育指数(mental development index,MDI)均高于医学干预组(P<0.05),6、12月龄运动发育指数(psychomotor development index,PDI)均高于医学干预组(P<0.05),与健康对照组比较MDI与PDI差异均无统计学意义(P>0.05)。24月龄医教结合组幼儿情绪四个维度的阳性率均明显低于医学干预组(P<0.01);与健康对照组比较,外化、内化、失调三个维度的阳性率差异无统计学意义(P>0.05),能力域阳性率医教结合组低于健康对照组(P<0.05)。结论医教结合的早期干预模式,可更有效地促进高危儿智力发展、早期社会交往能力及良好情绪形成。

Objective To explore a better way of early intervention on high-risk infants by combination of education with medical treatment. Methods One month old infants with high risk who were followed-up in out-patient clinic from June 2010 to January 2011 were enrolled in the research. Education with medical treatment group （140 cases）, medical treat- ment group （142 cases）,health control group （125 cases）. Children＇s mental development and psychomotor development in three groups were evaluated in 6,12 and 24 months old. Children＇s emotional sociality in three groups were evaluated in 24 months old. Results Mental development index （MDI） in the education with medical treatment group were dramatically improved than those of in the medical treatment group in different ages（P〈0.05） ;Psychomotor development index （PDI） in the education with medical treatment group were dramatically improved than those of in the medical treatment group in 6 and 12 months old（P〈0.05）;No different of MDI and PDI between in the education with medical treatment group and in the health control group. The positive ratio of four dimensions of toddler emotion in the education with medical treatment group were dramatically reduced than those of in the medical treatment group in 24 months （P〈0.01）. No different of the positive ratio of extroversion region,introversion region and imbalance region between the education with medical treatment group and the health control group （P〉0.05）. But the positive ratio of ability region was dramatically reduced than that of in the health control group （P〈0.05）. Conclusion Comparison with simple medical treatment,partten of early interven- tion of education with medical treatment can promote mental development, social-association ability and good emotion devel- opment of high-risk infants to a great extent.