儿童早期综合发展模式在早产儿中的应用研究

Study on the application of early comprehensive development model in premature infants

目的：探讨早期综合发展模式对早产儿体格、智能及神经心理发育的影响，探索早产儿早期综合发展模式在儿保门诊普遍应用的可行性。方法干预组90例早产儿从出院前开始介入，进行连续监测及综合干预，包括常规系统保健、养育指导、亲子活动、发育监测、智力测评、个体化指导等，对有异常情况者及时矫治；对照组90例在纠正月龄1个月后进行常规儿童保健。结果3月龄时对照组检出神经系统异常192例次，干预组检出129例次，对照组神经系统异常检出率高于干预组（χ2=14.574，P=0.000）；干预组12月龄时身长为（74.31±2.34）cm，对照组为（72.82±2.13）cm；干预组12月龄时体质量为（9.42±0.93）kg，对照组为（8.11±0.90）kg，干预组的体质量、身长的增长均高于对照组，差异有统计学意义（t=4.467、9.602，P<0.05）；同时测评智能发育水平，干预组大运动（96.40±7.83）分，精细动作（95.45±7.87）分，适应能力（98.33±10.87）分，社交行为（105.65±7.51）分，发育商（101.45±7.36）分，对照组分别为（92.53±6.57）、（89.27±8.02）、（94.26±9.88）、（100.31±8.13）、（95.65±6.93）分，2组差异有统计学意义（t=2.628～5.443，P<0.05）。结论儿童早期综合发展模式在早产儿中的应用，能早期发现神经发育偏离的儿童，有助于对早产儿进行早期干预，采用家庭与门诊相结合的干预模式，可减少神经系统异常的发生，提高智力测评各能区的发育水平，促进早产儿的智能、运动发育和社会适应能力。

Objective To discuss the effect of early comprehensive development mode on physical, intelligence and mental development of premature infants, and explore the feasibility of comprehensive development mode of preterm infants generally applied in child care clinic. Methods 90 cases of premature infants in intervention group from the beginning of the hospital before the intervention, continuous monitoring and comprehensive intervention including general system health, parenting guidance, family activities, growth monitoring, intelligence assessment, individualized instruction, and so on, for the timely correction of the anomalies. The 90 infants in the control group were only given conventional child health care after 1 month of corrected age. Results The nervous system abnormalities were detected 192 person-times in control group, while 129 person-times in intervention group at 3 months old, the detected rate of nervous system anomaly was higher in the control group than that in the intervention group (χ2=14.574, P=0.000). The body length of the intervention group was (74.31± 2.34) cm, the control group was (72.82 ± 2.13) cm. The body weight of the intervention group was (9.42 ± 0.93) kg, the control group was (8.11 ± 0.90) kg at 12 months old. The growth of weight and length of intervention group were higher than those of control group. The difference was statistically significant ( t=4.467, 9.602, P < 0.05). The development quotient was also assessed, the big activity sport, fine motor, adaptability, social behavior, development quotient of intervention group were (96.40±7.83) points, (95.45± 7.87) points, (98.33±10.87) points, (105.65±7.51) points, (101.45±7.36) points, and the control group were (92.53±6.57) points, (89.27±8.02) points, (94.26±9.88) points, (100.31±8.13) points, (95.65±6.93) points. The difference was statistically significant (t=2.628-5.443, P < 0.05). Conclusions Application of integrated early childhood development in premature infants can find early neurodevelopmental deviations of children and contribute to early intervention on premature infants. Using a combination of family and outpatient intervention may reduce the incidence of neurological abnormalities, improve the level of development of the intelligence assessment and promote premature infant intelligence, motor development and social adaptation ability.