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目的 探讨分级分类管理与直接管理模式在早产儿出院后的应用价值,为改善患儿预后提供参考.方法 回顾性分析孝感市中心医院120例早产儿病例资料,将开展分级分类管理前(2013年1月-12月)接受出院后妇幼保健院直接管理的60例早产儿作为对照组,将开展分级分类管理后(2014年1月-12月)接受出院后社区卫生服务中心、妇幼保健院及孝感市中心医院儿科三级分类管理的60例早产儿作为观察组.所有早产儿随访至少2年且均已完成.比较两组早产儿出院后Gesell发育量表测定发育商(DQ)评分变化情况,记录并发症发生情况,分析并发症与多个能区DQ值相关性.结果 观察组早产儿出院6个月、12个月及24个月时适应性、大运动、精细运动、语言及个人社交的DQ值均显著高于对照组,差异有统计学意义(均P＜0.05).观察组出院后2年内并发症总发生率显著低于对照组,差异有统计学意义(x2=12.102,P＜0.05).适应性、大运动、精细动作、语言及个人社交与早产儿感染性疾病和贫血呈显著负相关性(P＜0.05).结论 早产儿出院后并发症发生可能与神经系统预后相关联,出院后采用分级分类管理能显著降低并发症发生率,有助于保护神经功能,改善患儿预后.“,”Objective To explore the application value of classification management mode and direct management mode in premature infants after hospital discharge,and provide a reference for improving prognosis of the premature infants.Methods The data of 120 premature infants from Xiaogan Central Hospital was analyzed retrospectively.The premature infants were divided into control group (60 premature infants receiving direct management after hospital discharge from January to December in 2013) and observation group (60 premature infants receiving classification management after hospital discharge in Community Healthcare Center,Matemal and Child Health Care Hospital,and Xiaogan Central Hospital from January to December in 2014).All the premature infants were followed up for at least 2 years.The changes of development quotient (DQ) were detected by Gesell Development Schedule in the two groups.The incidence rates of complications in the two groups were recorded.The correlations between complications and DQs of different domains were analyzed.Results DQ values of adaptation,gross motor,fine motor,language,and personal social intercourse at 6,12,and 24 months after hospital discharge in observation group were statistically significantly higher than those in control group (all P＜0.05).The total incidence rate of complications within 2 years after hospital discharge in observation group was statistically significantly lower than that in control group (x2 =12.102,P＜0.05).Adaptation,gross motor,fine motor,language,and personal social intercourse were significantly negatively correlated with infectious diseases and anemia in premature infants (P＜0.05).Conclusion The prevalence of complications in premature infants after hospital discharge may be related to the prognosis of nervous system,classification management after hospital discharge can significantly reduce the incidence rate of complications,protect nervous system function,and improve the prognosis of premature infants.