学龄前儿童发育相关影响因素的临床研究

Clinical study on related factors of development in preschool children

目的探究学龄前儿童发育的相关影响因素。方法回顾性分析2017年5月1日至2018年5月1日就诊于解放军总医院第四医学中心的445例拟进行全身麻醉手术的学龄前儿童的临床资料,根据丹佛发育筛查试验(Denver developmental screening test,DDST)筛查结果分为正常组(409例)和阳性组(36例)。445例学龄前儿童中120例有手术麻醉史,根据DDST筛查结果进一步将120例学龄前儿童分为对照组(DDST筛查正常,105例)和观察组(DDST筛查阳性,15例)。分析学龄前儿童发育的相关影响因素。结果阳性组的体重指数(body mass index,BMI)、手术麻醉史比例、租住房屋比例、剖宫产比例均显著高于正常组(P<0.05),父母文化程度、父母从事脑力劳动比例、独生子女比例均显著低于正常组(P<0.05)。多因素logistic回归分析结果显示,母亲职业为脑力劳动者是学龄前儿童DDST筛查阳性的独立保护因素(P<0.05),而高BMI、租住房屋、剖宫产是学龄前儿童DDST筛查阳性的独立危险因素(P<0.05)。观察组的既往手术麻醉时长≥3h和剖宫产比例显著高于对照组(P<0.05),父母文化程度、母亲从事脑力劳动比例显著低于对照组(P<0.05)。多因素logistic回归分析结果显示,母亲文化程度为本科及以上、母亲职业为脑力劳动者是经历手术麻醉的学龄前儿童DDST筛查阳性的独立保护因素(P<0.05),既往手术麻醉时长≥3h、剖宫产是经历手术麻醉的学龄前儿童DDST筛查阳性的独立危险因素(P<0.05)。结论BMI、租住房屋、剖宫产、母亲职业是学龄前儿童发育的影响因素,对于经历手术麻醉的学龄前儿童,其发育受既往手术麻醉时长影响。

Objective To evaluate related factors of development in preschool children.Method The clinical data of 445 children admitted to the Fourth Medical Center of PLA General Hospital from May 1st,2017 to May 1st,2018 were retrospectively analyzed,and the patients were divided into normal group(409 cases)and positive group(36 cases).120 cases had a history of surgical anesthesia,and they were divided into control group(105 cases)and observation group(15 cases).To analyze related factors of development in preschool children.Result BMI,the proportion of surgical anesthesia history,rented house and cesarean section in positive group were significantly higher than those in normal group(P<0.05),and the proportion of parents’educational level,parents engaged in mental labor and the proportion of only child were significantly lower than those in normal group(P<0.05).Maternal occupation as a mental worker was an independent protective factor(P<0.05),while high BMI,rented house,cesarean section were independent risk factors(P<0.05).The proportion of surgical anesthesia duration≥3h and cesarean section in the observation group were significantly higher(P<0.05),and the proportion of parents’educational level and mothers engaged in mental labor were significantly lower than those in the control group(P<0.05).Mothers with high education and mental labor were independent protective factors(P<0.05),duration of surgical anesthesia≥3h,cesarean section were independent risk factors in preschool children undergoing surgical anesthesia(P<0.05).Conclusion BMI,rented house,cesarean section and maternal occupation are the influencing factors of preschool children’s development.For preschool children undergoing surgical anesthesia,their development is affected by the duration of surgical anesthesia.