神经行为发育监测及早期干预对高危儿智能发育的影响

Mpacts of Neurobehavior Growth Monitoring and Early Intervention on Intellectual Development of High-risk Infants

目的研究神经行为发育监测及早期干预对高危儿智能发育的影响。方法对产科登记的高危新生儿180例建"跟踪服务卡",随机分为干预组和对照组,每组各90例,同时选取80例同期出生的正常新生儿作为正常对照组,一并转至儿童早期发展中心,由儿科医师定期进行神经行为发育监测,对可疑脑损伤儿重点监测并干预指导。结果各组均在6个月和12个月时进行智能发育测试,其结果显示6个月时高危干预组5方面的DQ均高于对照组(P<0.01),高危干预组和正常对照组的大运动、精细动作、言语能和应人能4 个能区的DQ 差异无统计学意义(P >0.05);高危干预组的应物能DQ低于正常对照组(P<0.05)。1岁时高危干预组5方面的DQ明显高于高危对照组(P<0.01);高危干预组和正常对照组比较,5个能区的DQ差异无统计学意义(P>0.05);高危对照组5个能区的DQ明显低于正常对照组(P<0.01)。结论神经行为发育监测及早期干预可促进高危儿智能的发育,从产科入手,生后做好随访筛查管理是改善高危儿预后的有效手段。

Objectives To study impacts of neurobehavior growth monitoring and early intervention on intellectual development of high-risk infants. Methods“Tracking service cards”were established for 180 cases of high-risk infants registered in obstetrical department. Divide them into intervention group and control group of 90 cases respectively. Meanwhile, 80 cases of healthy infants born in the same period were selected as normal control group. Send all the groups to the Children Early Development Center, so their neurobehaviors are monitored by pediatricians regularly. Children with potential brain damage are monitored intensively and received intervention guide. Results All the groups were tested on their intellectual development after 6 months and 12 months. The result showed that after 6 months, 5 aspects of DQ of high-risk group were higher than the control group（P〈0.01）;differences of 4 aspects of DQ–gross motor,ifne motor, linguistics, and person-social abilities were not statically signiifcant（P〉0.05）;cognitive adaptive ability of high-risk intervention group was lower than normal control group（P〈0.05）. After 12 months, 5 aspects of DQ of high-risk intervention group were higher than high-risk control group（P〈0.01）;differences of 5 aspects of DQ between high-risk intervention group and normal control group were not statically signiifcant（P〉0.05）;5 aspects of DQ of high-risk control group were signiifcantly lower than normal control group（P〈0.01）. Conclusion Neurobehavior growth monitoring and early intervention can promote high-risk intellectual development. Management of follow-up screening in obstetrical department is effective to improve prognosis of high-risk infants.