CAJ | 학술논문

目的探讨双胎早产儿神经精神发育情况,并分析其危险因素.方法将2010年6月至2012年6月在昆明医科大学第一附属医院新生儿病房住院的早产几分为2组:双胎早产儿为研究组,单胎早产儿为对照组.对其中88例早产儿在纠正胎龄1岁时行神经精神发育随访,由儿童保健科专人采用贝利婴幼儿发展量表进行测试,其中研究组根据量表正常测试结果分为神经精神发育异常组[智力发展指数(MDI)≤79分]和神经精神发育正常组(MDI ＞79分),并对2组资料进行统计学分析.结果研究组MDI得分频数分布呈偏态分布,其中59％(27/46例)为神经精神发育异常(MDI≤79分);对照组MDI得分频数分布呈近似正态分布,其中仅12％(5/42例)为神经精神发育异常.1岁时双胎早产儿头围、身长、体质量、MDI、精神运动发展指数(PDI)均低于单胎早产儿,差异均有统计学意义(P均＜0.05).单因素分析中双胎早产儿神经精神发育异常的高危因素有胎龄、出生体质量、母亲育龄、父母亲文化程度、喂养方式、新生儿高胆红素血症、新生儿低血糖症、新生儿脓毒症、感染.多因素Logistic回归分析显示新生儿高胆红素血症是双胎早产儿神经精神发育异常的独立危险因素.结论同胎龄双胎早产儿的神经精神发育落后于单胎早产儿.新生儿高胆红素血症有可能是导致双胎早产儿神经精神发育异常的高危因素,早期积极处理新生儿高胆红素血症有利于促进双胎早产儿的神经精神发育.
목적 탐토쌍태조산인신경정신발육정황,병분석기위험인소.방법 장2010년6월지2012년6월재곤명의과대학제일부속의원신생인병방주원적조산궤분위2조:쌍태조산인위연구조,단태조산인위대조조.대기중88례조산인재규정태령1세시행신경정신발육수방,유인동보건과전인채용패리영유인발전량표진행측시,기중연구조근거량표정상측시결과분위신경정신발육이상조[지력발전지수(MDI)≤79분]화신경정신발육정상조(MDI ＞79분),병대2조자료진행통계학분석.결과 연구조MDI득분빈수분포정편태분포,기중59％(27/46례)위신경정신발육이상(MDI≤79분);대조조MDI득분빈수분포정근사정태분포,기중부12％(5/42례)위신경정신발육이상.1세시쌍태조산인두위、신장、체질량、MDI、정신운동발전지수(PDI)균저우단태조산인,차이균유통계학의의(P균＜0.05).단인소분석중쌍태조산인신경정신발육이상적고위인소유태령、출생체질량、모친육령、부모친문화정도、위양방식、신생인고담홍소혈증、신생인저혈당증、신생인농독증、감염.다인소Logistic회귀분석현시신생인고담홍소혈증시쌍태조산인신경정신발육이상적독립위험인소.결론 동태령쌍태조산인적신경정신발육락후우단태조산인.신생인고담홍소혈증유가능시도치쌍태조산인신경정신발육이상적고위인소,조기적겁처리신생인고담홍소혈증유리우촉진쌍태조산인적신경정신발육.
Objective To explore the neuropsychological development in twin premature infants,and to analyze the risk factors for the retardation of development.Methods The premature infants hospitalized in the Neonatal Ward First Affiliated Hospital of Kunming Medical University from Jun.2010 to Jun.2012 were divided into study groups of twin premature infants and a control group of singleton premature infants.The neuropsychological development of 88 premature infants was evaluated at corrected gestational age of 1 year old by Bayley scales of infant development.According to normal lab findings of the Bayley scales of infant development,the premature infants were then divided into abnormal neuropsychological development group [mental development index(MDI) ≤79 scores] and normal neuropsychological development group (MDI ＞ 79 scores),and the data of 2 groups were statistically analyzed.Results The frequency distribution of MDI score in study group showed a skewed distribution,of which 59％ (27/46 cases) had abnormal neuropsychological development (MDI ≤ 79 scores); However,the frequency distribution of MDI score in control group showed an approximate normal distribution,of which only 12％ (5/42 cases) for abnormal neuropsychological development.Head circumference,body length,body weight,MDI,psycho-motor development index of twin premature infants of one-year old were lower than those of the singleton premature infants of the same age,and the differences were statistically significant (all P ＜0.05).The single factor analysis demonstrated that the risk factors for abnormal neuropsychological development (MDI ≤ 79 scores) of twin premature infants were gestational age,birth weight,mother' s gcstational age,the cultural degree of parents,mode of feeding,neonatal hyperbilirubinemia,neonatal hypoglycemia and neonatal sepsis.Multiple regression analysis showed that neonatal hyperbilirubinemia was the independent risk factor for abnormal neuropsychological development of twin premature infants.Conclusions At same gestational age,neuropsychological development of twin premature infants lagged behind singleton premature infants.Neonatal hyperbilirubinemia may be the risk factors for neuropsychological development of twin premature infants,so the earlier management of neonatal hyperbilirubinemia may be beneficial for the neuropsychological development of twin premature infants.