早期干预对33周以下早产儿2~3岁时神经发育影响的随访研究

目的 探讨早期干预对33周以下早产儿2~3岁时神经发育的影响,为制定深圳市早产儿早期干预模式及流程提供依据.方法 选择2012年4~12月期间在龙岗区出生的33周以下早产儿150例,其中75例早产儿1岁以内接受早期干预(干预组),75例给予常规的保健指导(对照组);随机抽取同期出生的75例足月儿作为足月组.在早产儿矫正年龄2岁、3岁时用格赛尔发展量表(Gesell)行智能发育评估,比较各组早产儿的脑瘫、语言发育迟缓和精神发育迟滞的发生率.结果 对照组早产儿2岁时的精细运动、语言理解能力评分分别为(95.29±9.70)分、(91.20±9.44)分,均低于干预组的(98.84±9.41)分、(95.21±9.56)分,差异均有统计学意义(P<0.05);对照组早产儿3岁时的精细运动、语言理解能力评分分别为(96.76±10.37)、(93.47±9.70)分,均低于干预组的(101.80±10.24)、(97.86±9.93)分,差异均有统计学意义(P<0.05);干预组早产儿2岁时的神经系统异常检出率为4.00%,明显低于对照组的16.00%,3岁时的神经系统异常检出率为2.67%,明显低于对照组的13.33%,差异均有统计学意义(P<0.05),干预组早产儿2岁及3岁时的神经系统异常检出率与足月组比较差异均无统计学意义(P>0.05).结论 对33周以下早产儿1岁以内进行早期干预能降低早产儿2~3岁时神经系统发育异常的发生率,改善早产儿预后.

Follow-up study of the effect of early intervention on the neural development of the 2-3-year-old premature infant less than 33 weeks'gestation

Objective To study the effect of early intervention on the neural development of the 2-3-year-old premature infant less than 33 weeks' gestation, and to provide evidence for the early intervention model and process of premature infants in Shenzhen. Methods A total of 150 premature infants, born in Longgang District from April 2012 to December 2012, were selected and divided into the intervention group (who received early intervention) and the con-trol group (who received routine health guidance), with 75 cases in each group. Seventy-five full term infants randomly were selected as the full-term group during the same period. The incidence of cerebral palsy, language development and mental retardation in the preterm infants of the three groups were compared by Gesell Infant Development Scale (Gesell) at the age of 2 and 3 years. Results The fine motor, language comprehension scores of the control group at 2 years old were respectively (95.29±9.70) points, (91.20±9.44) points, which were significantly lower than (98.84±9.41) points and (95.21 ± 9.56) points of the intervention group, with statistically significant differences (P<0.05). The fine motor, lan-guage comprehension scores of the control group at 3 years old were respectively (96.76±10.37) points and (93.47±9.70) points, which were significantly lower than (101.80 ± 10.24) points and (97.86 ± 9.93) points of the intervention group, with statistically significant differences (P<0.05). The neurological abnormalities rate of the intervention group at 2 years old was 4.00%, which was significantly lower than 16.00%of the control group (P<0.05). The neurological abnor-malities rate of the intervention group at 3 years old was 2.67%, which was significantly lower than 13.33%of the con-trol group (P<0.05). There was no difference between the intervention group and the full-term group at 2-3-year-old in the neurological abnormalities rate. Conclusion Early intervention in one-year old infants can reduce the incidence of nervous system abnormal development of 2-3-year-old premature infants less than 33 weeks' gestation, and improve the prognosis of premature infants less than 33 weeks' gestation.