CAJ | 학술논문

背景:近年来,早产儿的存活率逐年上升,但由于早产儿大脑发育不成熟,智能发育往往较正常儿落后.目的:探讨以家庭为中心,以物质营养、信息刺激和爱抚为主要干预内容的早期干预对早产儿婴儿期智能发育水平的影响.设计:随机抽样对照观察.单位:山东大学临床医学院·济南市中心医院儿科.对象:选择2000-05/2002-07在济南市中心医院出生的孕31～36周早产儿35例(男18例,女17例)作为早期干预对象,同时设立同期出生的孕31～36周早产儿33例(男18例,女15例)和足月新生儿49例(男26例,女23例)为对照组.方法:以家庭为中心,以营养、信息刺激和爱抚为主要干预内容进行早产儿早期干预,建立健康档案,进行抚触和穴位按摩,1个月内家访2次;两对照组只在3,6,10月龄常规体检一次.在10月龄时采用Gesell发育诊断量表和日本S～M社会生活能力量表对各组婴儿的智能发育水平进行评定.主要观察指标:各组婴儿智能发育水平评定结果.结果:在实验过程中,早产儿干预组死亡1例,失访2例,合格病例32例,合格率91%.早产儿对照组33例,失访3例,合格病例30例,合格率91%.足月儿对照组49例,失访3例,合格病例46例,合格率94%.①早产儿干预组10月龄时Gesell各能区的发育商DQ及日本S～M社会生活能力评定值均显著高于早产儿对照组,其中适应性、精细动作、语言、个人社会行为4项发育商差异具有高度显著性意义.②早产儿干预组10月龄时Gesell各能区的发育商DQ及日本S～M社会生活能力评定值均低于足月儿对照组,差异有显著性意义.③干预组中胎龄大于35周的早产儿各评定值均低于足月儿对照组,但差异无显著性意义(P＞0.05).结论:早期干预对早产儿婴儿期智能发育有明显的促进作用,部分早产儿经干预可达到足月儿水平.
배경:근년래,조산인적존활솔축년상승,단유우조산인대뇌발육불성숙,지능발육왕왕교정상인락후.목적:탐토이가정위중심,이물질영양、신식자격화애무위주요간예내용적조기간예대조산인영인기지능발육수평적영향.설계:수궤추양대조관찰.단위:산동대학림상의학원·제남시중심의원인과.대상:선택2000-05/2002-07재제남시중심의원출생적잉31～36주조산인35례(남18례,녀17례)작위조기간예대상,동시설립동기출생적잉31～36주조산인33례(남18례,녀15례)화족월신생인49례(남26례,녀23례)위대조조.방법:이가정위중심,이영양、신식자격화애무위주요간예내용진행조산인조기간예,건립건강당안,진행무촉화혈위안마,1개월내가방2차;량대조조지재3,6,10월령상규체검일차.재10월령시채용Gesell발육진단량표화일본S～M사회생활능역량표대각조영인적지능발육수평진행평정.주요관찰지표:각조영인지능발육수평평정결과.결과:재실험과정중,조산인간예조사망1례,실방2례,합격병례32례,합격솔91%.조산인대조조33례,실방3례,합격병례30례,합격솔91%.족월인대조조49례,실방3례,합격병례46례,합격솔94%.①조산인간예조10월령시Gesell각능구적발육상DQ급일본S～M사회생활능력평정치균현저고우조산인대조조,기중괄응성、정세동작、어언、개인사회행위4항발육상차이구유고도현저성의의.②조산인간예조10월령시Gesell각능구적발육상DQ급일본S～M사회생활능력평정치균저우족월인대조조,차이유현저성의의.③간예조중태령대우35주적조산인각평정치균저우족월인대조조,단차이무현저성의의(P＞0.05).결론:조기간예대조산인영인기지능발육유명현적촉진작용,부분조산인경간예가체도족월인수평.
BACKGROUND: Recently, the survival rate of premature infants increases year by year, but the cerebral growth of premature infants is immature, so the intellectual development of premature infants is slower than that of normal infants.OBJECTIVE: To explore the effect of family-oriented early intervention,which took material nutrition, information stimulation and petting as main interventional content, on level of intellectual development in premature infants in infantile age.DESIGN: Randomized sampling controlled observation.SETTING: Department of Pediatrics, Clinical Medical College of ShanPARTICIPANTS: Totally 35 premature infants of 31-36 weeks (18 males and 17 females) were enrolled as early interventional subjects, who were born at Jinan Municipal Central Hospital between May 2000 and July 2002. Meanwhile, 33 premature infants of 31-36 weeks (18 males and 15females) born in the same period and 49 mature neonates (26 males and 23females) were enrolled in control group.METHODS: The family-oriented early intervention, which considered nutrition, information stimulation and petting as chief interventional content,were performed in premature infants, and health archives was established.Taction and point massage were conducted. Home visit was done twice in one month. One routine health examination was determined at 3, 6 and 10months in the two control groups. The level of intellectual development was assessed in infants of 10-month old of each group with Gesell Developmental Schedules (GDS) and Japanese S-M Social Living Ability Scale.MAIN OUTCOME MEASURES: Evaluation of level of intellectual development in infants of each group.RESULTS: In the premature interventional group, 1 premature infant died, 2 withdrew from the study, and 32 eligible cases with the eligible rate of 91.4%; Among the 33 premature infants in the premature control group, there were 3 withdrawing from the study, and 30 eligible cases with the eligible rate of 90.9%. Among the 49 infants in the term infant control group, there were 3 withdrawing from the study and 46 eligible cases with the eligible rate of 93.9%. ①Developmental quotient (DQ) at each area of Gesell and evaluation of Japanese S-M Social Living Ability Scale were significantly higher in the premature interventional group than those in the premature control group at 10 months old. There were extremely significant differences in suitability, fine activity, language and individual social behavior. ②DQ at each area of Gesell and evaluation result of Japanese S-M Social Living Ability Scale were lower in the premature interventional group than those in the term infant control group at 10 months old, which had obvious difference. ③Evaluation in premature infants aged oyer 35 weeks of the interventional group was lower than that in the term infant control group, but there was insignificant difference (P ＞ 0.05).CONCLUSION: Early intervention has a marked effect in improving the intellectual developme nt of premature infants, and some premature infants can recover to the level of term infants in intelligence development after intervention.