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【目的】探讨分级干预方法对早产儿神经运动行为发育的影响。【方法】门诊常规对302例早产儿建立系统监测档案,逐月进行随访,内容包括一般反应、运动发育水平、肌张力、神经反射等,在3、6、9月根据发育水平异常程度不同分为4级,同时根据不同级别进行相应的管理方法。于9月龄时做Gesell发育商测试,DQ低于75为异常,记录异常发生率,并与同期出生的正常足月儿113例Gesell测试结果比较。【结果】参与分级干预后,302例早产儿的级别在不同月龄间处于动态变化中,其中尤以1、2、3级变化明显。9月龄时,1级185人(61%),2级45人(15%);3级66人(22%);4级6人(2%)。各级Gesell测试与足月正常儿比较,1、2级各项发育与足月儿差异无统计学意义(P>0.05),3级仅语言和个人—社交差异有统计学意义(P<0.05),4级者各项发育障碍则显著高于正常儿及其他各级早产儿。【结论】通过对302例早产儿的分级及相应干预,9月龄时76%可回归正常足月儿水平,仅24%需要继续干预,说明对其的分级管理有效可行。
【Objective】 To investigate the effect of grading intervention on the development of neural motor in premature infants. 【Methods】 Outpatient routinely established 302 surveillance files for preterm infants and followed up monthly. The contents included general reaction, motor development, muscle tone and nerve reflex. According to the abnormal levels of development level in different months For 4, at the same time according to the different levels of the corresponding management methods. The Gesell Developmental Test was performed at 9 months of age with DQ less than 75 as an abnormality and the incidence of abnormalities was recorded and compared with 113 cases of Gesell test results of normal full-term infants born in the same period. [Results] After participating in grading intervention, the level of 302 preterm infants was dynamically changed in different months of age, especially the changes of 1,2,3 grade obviously. At age nine months, Level 1 185 (61%), Level 2 45 (15%); Level 3 66 (22%); Level 4 6 (2%). There was no significant difference between Grade 1 and Grade 2 children (P> 0.05), Grade 3 language only and individuals - Social difference was statistically significant (P <0.05 ), Grade 4 of all developmental disorders were significantly higher than normal children and other levels of premature children. 【Conclusion】 Through the classification and intervention of 302 premature infants, 76% return to normal full-term children at 9 months of age, and only 24% need continuous intervention, indicating that the grading management is effective and feasible.