儿童全面发育迟缓的危险因素及干预措施分析

Analysis of risk factors and intervention measures for children with developmental delay

目的探讨儿童全面发育迟缓(GDD)患儿与的危险因素及干预措施分析。方法选取医院收治的GDD患儿80例作为GDD组,选取同期入院体检正常儿童60例作为对照组,分析GDD的危险因素。根据治疗方案不同将GDD组再分为两亚组,49例接受个体化治疗(个性化干预组);31例因各种原因未接受入院治疗,仅接受家庭干预(家庭干预组)。持续干预6个月后,采用GESELL发育量表(GDS)中文修订版评估发育情况,并计算总的发育商(DQ)。结果 GDD组发生妊娠期并发症、宫内发育迟缓、先兆流产、孕周<37 w、低出生体质量、围生期窒息、新生儿缺氧缺血性脑病的概率高于对照组(P<0.05);多因素Logisitic回归分析显示,妊娠期并发症、孕周<37 w、宫内发育迟缓、围生期窒息是GDD发生的独立危险因素。个性化干预组干预后,GM、FM、AD、L、PS、DQ均高于家庭干预组(P<0.05)。结论母体妊娠期相关并发症、孕周<37 w、宫内发育迟缓、围生期窒息是GDD发生的独立危险因素,早期个性化干预治疗GDD,可减轻患儿运动、语言、智力发育障碍。

Objective To explore the risk factors and intervention measures for children with global developmental delay （GDD）.Methods A total of 80 children with GDD to receive treatment in our hospital were selected to constitute a GDD group, and another 60 children in normal condition to receive physical examination in our hospital in the same period were selected to constitute a control group, so as to analyze the risk factors of GDD. The GDD group was divided into two sub groups according to the different treatment plans, i.e., an individualized intervention group（n=49） to receive individualized treatment and a family intervention group （n=31） to receive intervention from their family only but not admitted to the hospital for various reasons. After six months＇ continuous intervention, the developmental status was assessed by use of the Chinese version of GESELL developmental scale （GDS） and the total developmental quotient （DQ） was calculated.Results The probabilities of pregnancy complications, intrauterine growth retardation （IUGR）, threatened abortion, gestational age 〈37 w, low birth weight, birth asphyxia, and neonatal hypoxic-ischemic encephalopathy in the GDD group were higher than those in the control group （P 〈 0.05）; the multivariate logistic regression analysis showed that pregnancy complications, gestational age 〈37 w, IURT, and birth asphyxia were independent risk factors for GDD. After intervention, GM, FM, AD, L, PS and DQ in the individualized intervention group were higher than those in the control group （P 〈 0.05）.Conclusion The pregnancy complications, gestational age 〈37 w, IURT, and birth asphyxia are independent risk factors for GDD. Individualized early intervention in the treatment of GDD can relieve the children＇s movement and language development delay and mental retardation.