多学科合作的早产儿系统管理对新生儿重症监护室出院早产儿神经精神发育结局的影响

Impact of a multidisciplinary team systematic management on the neurodevelopmental outcomes of neonatal intensive care unit preterm infants

目的分析多学科合作系统管理和早期综合干预对新生儿重症监护室(NICU)出院早产儿近期神经发育结局的影响。方法回顾分析和比较在上海市儿童医院早产儿整合门诊接受随访的早产儿,根据管理模式分为非系统管理且无干预阶段,以及多学科合作开展系统管理阶段,比较两阶段NICU出院早产儿发育迟缓发生率;通过对照研究评价多学科合作的系统管理对NICU早产儿近期神经发育结局的影响。结果1999年1月-2016年6月累计登记随访NICU出院早产儿997例,两阶段中早产儿随访至校正12月龄段时,系统管理下的早产儿各能区发育迟缓发生率较低(P<0.05)。对照研究表明,NICU出院早产儿接受系统管理后,校正18月龄发育商可达平均水平。结论多学科合作开展系统的随访管理,能改善NICU出院早产儿近期神经精神发育结局。

Objective To analyze the impact of systematically follow-up and early intervention on the recent neurode- velopmental outcomes of neonatal intensive care unit （NICU） preterm infants in a multidisciplinary team （MDT） frame- work. Methods Retrospective analysis and intervention-controlled study were conducted. The developmental abnormali- ties ratio of the recorded preterm infants discharged from Shanghai Children＇s Hospital were analyzed and the outcomes were compared with those under systematically follow-up and early intervention The impact of MDT systematically follow-up and early intervention on the neurodevelopmental outcomes of NICU preterm infants were evaluated through a prospective inter- vention-controlled study. Results Totally 997 infants discharged from NICU were recorded and analyzed from Jan. 1999 to J un. 2016 Infants with systematically follow-up and early intervention had lower developmental abnormalities ratio （P〈 0.05）. Intervention controlled study further showed that infants in intervention group could be developed to the average scores. Conclusion Preterm infants discharged from NICU need systematically follow-up and effectively early intervention by specialist in a MDT framework to make sure a better outcome.