早期干预及依从性对早产儿1岁时生长发育的影响

Effect of early intervention and compliance on growth and development of preterm infants at 1 year of age

目的 探讨早期干预及干预依从性对早产儿1岁时体格发育和精神运动发育的影响,为促进早产儿生长发育提供依据。方法 以2010年12月—2013年12月安徽省儿童医院新生儿科收治的151例早产儿为研究对象,对早产儿出院后进行定期随访至校正年龄12个月,根据随访频次分为依从性良好组（63例）和依从性较差组（88例）,比较2组早产儿体格发育和精神运动发育指标的差异。结果 校正年龄12个月时,依从性较差组早产儿身长和体重均低于依从性良好组[（76.5±3.1）cm vs.（77.7±2.4）cm,（9.82±1.20）kg vs.（10.51±1.25）kg],且差异均有统计学意义（t=-2.456、t=-3.439,均P〈0.05）。依从性较差组运动发育指数（psychomotor development index,PDI）和智能发育指数（mental development index,MDI）均低于依从性良好组[（76.6±13.7）分vs.（84.0±13.0）分,（82.3±13.6）分vs.（88.0±15.7）分],且差异均有统计学意义（t=-3.347、t=-2.398,均P〈0.05）;依从性较差组PDI〈70分的发生率高于依从性良好组（26.1%vs.12.7%）,差异有统计学意义（χ2=4.064,P〈0.05）,脑瘫的发生率2组之间差异无统计学意义。结论 早期干预可以促进早产儿生长发育,良好的依从性有助于提高早产儿追赶性生长和精神运动发育,减少发育障碍的风险。

Objective To explore the effect of early intervention and the compliance of patients on physical growth and neurodevelopment of preterm infants at 1 year of age, provide a basis for intervention on development of preterm infants. Methods Total 151 cases of preterm in department of neonatology of Anhui provincial Children＇ s Hospital from Dec. 2010 to Dec. 2013 were enrolled and divided into good compliance group（63 cases） and poor compliance group（ 88 cases） by following up for one year. The body weight and body length, psychomotor development index （PDI）and mental development index （MDI） in the two groups were compared. Results The body weight and length of poor compliance group were lower than those of good compliance group[ （76.5 ± 3.1 ） cm vs. （77.7 ± 2.4） cm, （9.82 ± 1.20） kg vs. （ 10.51 ± 1.25 ）kg] , and the differences were statistical significance（ t = -2. 456,t = -3. 439, P 〈 0.05 ）. The index of PDI and MDI of poor compliance group were lower than those of good compliance group[ 76.6 ± 13.7 vs. 84.0 ± 13.0,82.3 ± 13.6 vs 88.0 ± 15.7 ] , and the differences were statistical significance （ t = - 3. 347 ,t = - 2. 398, P 〈 0.05 ）. The incidence of PDI 〈70 in of poor compliance group was higher than that of good compliance group（26.1% vs. 12.7% ,X2 = 4.064,P 〈0.05） at corrected gestational age for 12 months. But there was no significant difference for cerebral palsy. Conclusion Early intervention can promote the development of preterm infants,good compliance with follow up and intervention can improve the catch-up growth and Psychomotor development, reduce the risk of developmental disorders.