早期干预对早产儿和低出生体质量儿婴儿期行为发育的影响

背景中国在早产儿和低出生体重儿早期干预方面的研究起步较晚,且对早期干预作用的评估基本上都在1岁或1岁以后.目的探讨早期干预对早产儿和低出生体质量儿婴儿期行为发育的作用.设计随机对照的实验研究.地点、对象和干预选择在南京医科大学第二附属医院出生的早产儿、低出生体质量儿60例,按随机的方式分为实验组和对照组,实验组30例,男16例,女14例.平均出生体质量为(2 268±531)g.对照组30例,男16例,女14例.平均出生体质量为(2 307±398)g.应用南京医科大学陈荣华教授和邓静云教授等人设计的一套用于0-3岁儿童早期教养的方案.具体方法是在实验组婴儿出生时,1,3,6,9,12个月时到早期教育门诊由医生指导家长如何训练孩子,要求家长每天在家完成训练任务,同时随访监测孩子的体格生长和行为发育情况.主要观察指标实验组和对照组3,6,9,12个月的发育商.结果实验组在适应性、大运动、精细动作、语言和社会交往5个能区上的发育商均值在各月龄段都高于对照组,且从3个月开始在精细动作和社会交往能区与对照组存在统计学差异.在12个月龄阶段实验组和对照组婴儿各能区的发育商均值,除了大运动能区(91±8,86±10)差异有显著性意义(t=2.022,P＜0.05)外,适应性(97±5,89±4)、精细动作(98±10,88±8)、语言(98±7,89±8)和社会交往(102±7,95±10)4个能区的发育商差异均有显著性意义(t=2.839～5.719,P＜0.01).结论早期干预对早产儿和低出生体重儿的行为发育在婴儿期就有良好的促进作用,早期干预的实施应该越早越好.

Effects of early interventions to behavior development in infancy among premature and infants with low body mass at birth

BACKGROUND: The beginning of the research on early interventions of premature and low birth body mass infants was a bit late. Evaluations on the effects of early interventions were just done at 1 year old or after 1 year old.OBJECTIVE: To discuss the effects of early interventions on infancy behavior development in premature and low birth weight infants.DESIGN: Randomized case-control trial study.SETTING, PARTICIPANTS and INTERVENTION: Sixty cases of premature and low birth body infants were chosen from Second Affiliated Hospital of Nanjing Medical University and were randomly divided into experimental group and control group. The experimental group included 16 males and 14 females, the mean body mass at birth was(2 268 +531) g. In the control group, there were also 16 males and 14 females, the mean body mass at birth was(2 307 + 398) g. A set of early stage upbringing plan designed by Professors Chen RH and Deng JY of Nanjing Medical University, which targeted for 0 to 3-year-old children was applied. The parents of the control group would go to early education clinic to learn how to train children by the doctor's instruction when the infants were born and in the 1st, 3rd, 6th, 9th, 12thmonth after birth. It was required that the parents should complete the training tasks of everyday, at the same time, the growth of physical build as well as the development of behaviors should be followed up and monitored.MAIN OUTCOME MEASURES: Development quotients in the 3rd, 6th, 9thand 12th month of both experimental and control groups.RESULTS: The average values of five developmental quotients in adaptability, gross motor, fine motor, language and sociability in the experimentalgroup were higher than those in the control group. Moreover, there were statistical differences in fine motor and social communication between the two groups from the 3nd month. When in the 12th month, there were significant differences in adaptability(97 +5, 89 +4), fine motor(98 + 10, 88 ± 8),language (98 ± 7, 89 + 8) and social communication(102 ± 7, 95 ± 10) respectively between the experimental and control group( t = 2.839-5.719,P ＜ 0.01 ) besides the existing significant difference in gross motor(91 ± 8,86±10)(t =2.022, P ＜0.05).CONCLUSION: Early interventions play a favourable role in promoting the infancy behavior development among premature and low birth body mass infants, the earlier the implementation of early intervention the better effects there were.