中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
5期
379-383
,共5页
晚期早产儿%神经发育%新生儿行为神经测查%贝利婴儿发展量表
晚期早產兒%神經髮育%新生兒行為神經測查%貝利嬰兒髮展量錶
만기조산인%신경발육%신생인행위신경측사%패리영인발전량표
Late preterm infant%Neurodevelopment%Neonatal behavioral neurological assessment%Bayley scales of infant development
目的 前瞻性研究出生18月龄晚期早产儿的神经发育情况.方法 2009年1月至12月四川省成都市北部地区三家医院出生的7 584例活产新生儿,纳入标准的晚期早产儿89例,以健康足月儿170例为对照,随访18个月,矫正胎龄至40周时应用20项新生儿行为神经测查法,矫正年龄3、6、9、12和18月龄时应用贝利婴儿发展量表,进行神经行为发育评估,比较晚期早产儿和足月儿的神经行为发育情况.结果 成功随访的晚期早产儿63例,足月儿115例,矫正胎龄至40周时新生儿行为神经测查结果显示,晚期早产儿评分处于正常范围(≥37分)的比例明显低于足月儿(82.5％比94.8％),评分异常(＜35分)者明显高于足月儿(4.8％比0),评分处于临界值(35 ～ 36分)者明显高于足月儿(12.7％比5.2％),2组比较差异有统计学意义(Z=-2.707,P＜0.05);贝利婴儿发展量表测查结果显示,晚期早产儿运动发育指数(PDI)得分中位数在矫正年龄3、6、9、12月龄时低于足月儿,差异均有统计学意义(t=-4.266、-4.594、-5.663、-2.584,P均＜0.05);晚期早产儿智力发育指数(MDI)得分中位数在矫正年龄3、6、9、12月龄时低于足月儿,差异均有统计学意义(t=-7.121、-7.829、-7.038、-6.002,P均＜0.05);矫正年龄18月龄时MDI得分低于足月儿,差异有统计学意义(t=-4.115,P＜0.05),PDI得分虽低于足月儿,但差异无统计学意义(t=-0.957,P＞0.05).结论 晚期早产儿神经行为发育在出生第1年明显延迟,18月龄时其智能发育仍落后于足月儿.应制定适宜的早教措施,促进晚期早产儿早期的神经行为发育.
目的 前瞻性研究齣生18月齡晚期早產兒的神經髮育情況.方法 2009年1月至12月四川省成都市北部地區三傢醫院齣生的7 584例活產新生兒,納入標準的晚期早產兒89例,以健康足月兒170例為對照,隨訪18箇月,矯正胎齡至40週時應用20項新生兒行為神經測查法,矯正年齡3、6、9、12和18月齡時應用貝利嬰兒髮展量錶,進行神經行為髮育評估,比較晚期早產兒和足月兒的神經行為髮育情況.結果 成功隨訪的晚期早產兒63例,足月兒115例,矯正胎齡至40週時新生兒行為神經測查結果顯示,晚期早產兒評分處于正常範圍(≥37分)的比例明顯低于足月兒(82.5％比94.8％),評分異常(＜35分)者明顯高于足月兒(4.8％比0),評分處于臨界值(35 ～ 36分)者明顯高于足月兒(12.7％比5.2％),2組比較差異有統計學意義(Z=-2.707,P＜0.05);貝利嬰兒髮展量錶測查結果顯示,晚期早產兒運動髮育指數(PDI)得分中位數在矯正年齡3、6、9、12月齡時低于足月兒,差異均有統計學意義(t=-4.266、-4.594、-5.663、-2.584,P均＜0.05);晚期早產兒智力髮育指數(MDI)得分中位數在矯正年齡3、6、9、12月齡時低于足月兒,差異均有統計學意義(t=-7.121、-7.829、-7.038、-6.002,P均＜0.05);矯正年齡18月齡時MDI得分低于足月兒,差異有統計學意義(t=-4.115,P＜0.05),PDI得分雖低于足月兒,但差異無統計學意義(t=-0.957,P＞0.05).結論 晚期早產兒神經行為髮育在齣生第1年明顯延遲,18月齡時其智能髮育仍落後于足月兒.應製定適宜的早教措施,促進晚期早產兒早期的神經行為髮育.
목적 전첨성연구출생18월령만기조산인적신경발육정황.방법 2009년1월지12월사천성성도시북부지구삼가의원출생적7 584례활산신생인,납입표준적만기조산인89례,이건강족월인170례위대조,수방18개월,교정태령지40주시응용20항신생인행위신경측사법,교정년령3、6、9、12화18월령시응용패리영인발전량표,진행신경행위발육평고,비교만기조산인화족월인적신경행위발육정황.결과 성공수방적만기조산인63례,족월인115례,교정태령지40주시신생인행위신경측사결과현시,만기조산인평분처우정상범위(≥37분)적비례명현저우족월인(82.5％비94.8％),평분이상(＜35분)자명현고우족월인(4.8％비0),평분처우림계치(35 ～ 36분)자명현고우족월인(12.7％비5.2％),2조비교차이유통계학의의(Z=-2.707,P＜0.05);패리영인발전량표측사결과현시,만기조산인운동발육지수(PDI)득분중위수재교정년령3、6、9、12월령시저우족월인,차이균유통계학의의(t=-4.266、-4.594、-5.663、-2.584,P균＜0.05);만기조산인지력발육지수(MDI)득분중위수재교정년령3、6、9、12월령시저우족월인,차이균유통계학의의(t=-7.121、-7.829、-7.038、-6.002,P균＜0.05);교정년령18월령시MDI득분저우족월인,차이유통계학의의(t=-4.115,P＜0.05),PDI득분수저우족월인,단차이무통계학의의(t=-0.957,P＞0.05).결론 만기조산인신경행위발육재출생제1년명현연지,18월령시기지능발육잉락후우족월인.응제정괄의적조교조시,촉진만기조산인조기적신경행위발육.
Objective To study the neurodevelopmental outcome prospectively at 18 months of the late preterm infants.Methods Data from 7 584 live born neonates were collected between January and December.2009 in 3 hospitals located in the north of Chengdu City,Sichuan Province were collected,89 late preterm infants were brought into study ; 170 healthy full-term infants were chosen as the controls randomly.Neurodevelopment outcome was assessed by using neonatal behavioral neurological assessment(NBNA) at 40 weeks corrected gestational age,and Bayley scales of infant development was performed to obtain the physical development index (PDI) and mental development index (MDI) at 3,6,9,12 and 18 months corrected age.Neurodevelopmental outcome of late preterm infants was studied compared with that of the term infants.Results Sixty-three neonates born at the late preterm phase and 115 neonates born at the term phase were successfully followed up.The NBNA scores of the late preterm infants at 40 weeks corrected gestationa] age were significantly lower than those of the term infants.The proportion of the late preterm infants whose scores ≥37 was significantly lower than that of the term infants(82.5％ vs 94.8％),the proportion of late preterm infants whose scores ＜35 was significantly higher than that of the term infants(4.8％ vs 0),the proportion of the late preterm infants whose scores in 35-36 was significantly higher than that of the term infants (12.7％ vs 5.2％,Z =-2.707,P ＜ 0.05) ;At 3,6,9 and 12 months corrected age,the late preterm infants showed a significant lower PDI scores(t =-4.266,-4.594,-5.663,-2.584) and MDI scores (t =-7.121,-7.829,-7.038,-6.002) than those of the term infants(all P ＜0.05).Compared with the term infants,the late preterm infants still had lower MDI scores than the term infants at 18 months corrected age(t =-4.115,P ＜0.05),but no difference was observed in PDI scores between late preterm and the term infants (t =-0.957,P ＞ 0.05).Conclusions Neurodevelopment outcome of the late preterm infants is delayed in the first year compared with term infants.At 18 months corrected age the mental development is still delayed compared with the term infants.Measures should be taken properly to improve the neurodevelopment of the late preterm infants in the early childhood.
