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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。
BACKGROUND: In recent years, the survival rate of premature babies has been increasing year by year. However, due to immature brain development in premature babies, the development of intelligence is often lagging behind that of normal children. OBJECTIVE: To investigate the effect of early intervention with family-centered, substance-based intervention, information stimulation and caressing as the main interventions on the level of intelligence development in premature infants. Design: random sampling control observation. Unit: Shandong University School of Medicine · Jinan Central Hospital Pediatrics. PARTICIPANTS: 35 preterm infants (18 males and 17 females) born in Jinan City Central Hospital from May 2000 to July 2002 were enrolled as early intervention subjects and 31 to 36 weeks old 33 cases of preterm children (18 males and 15 females) and 49 full-term newborns (26 males and 23 females) as control group. Methods: Taking family as the center, taking the nutrition, information stimulation and caressing as the main intervention contents, the early intervention of preterm infants was established. The health files were set up. The massages and acupressure massages were performed. There were two visits within one month. 6, 10 months of age physical examination once. At the age of 10 months, the Gesell Developmental Diagnostic Questionnaire and the Japanese S-M Social Life Scale were used to assess the level of intelligence development in infants in each group. MAIN OUTCOME MEASURES: Assessment results of infant’s intelligent development level in each group. Results: During the experiment, 1 case died of premature infants, 2 cases were lost to follow-up, and 32 cases were eligible, the pass rate was 91%. 33 cases of preterm children control group, lost 3 cases, 30 cases of qualified cases, the passing rate of 91%. 49 cases of full-term children control group, lost 3 cases, 46 cases of qualified cases, the passing rate of 94%. (1) The scores of DQ and Gestational Social Support Rating (SQ) of Gesell in 10-month-old preterm infants in intervention group were significantly higher than that in preterm infants, including 4 items of adaptability, fine motor, language and personal social behavior Developers differences have a highly significant significance. (2) The assessment of social viability of DQ and Gestational age at Gesell in Gesell subpopulation of preterm infants at 10 months of age was lower than that of term infants, the difference was significant. ③In the intervention group, the preterm infants whose gestational age was more than 35 weeks were all lower than those of the full-term infants, but there was no significant difference (P> 0.05). Conclusion: Early intervention can significantly promote the infant’s premature infant’s intellectual development. Some premature infants may achieve full-term infant’s intervention by intervention.