72例早产儿体格生长及神经系统发育随访

发布时间：2018-01-26 13:53

  本文关键词： 早产儿 出院后 生长发育 神经发育　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:随访早产儿出院后体格生长及神经系统发育的情况,分析生长发育迟缓及神经系统发育异常的危险因素,为临床早期识别、合理干预治疗提供理论参考。方法:前瞻性分析2015年10月至2016年12月广西医科大学第一附属医院新生儿病房住院的早产儿,并根据出生体重、胎龄、是否小于胎龄儿(SGA)和出院后喂养方式、出院时是否为宫外生长发育迟缓(EUGR)分组,比较出院后体格生长及神经发育情况。结果:1.本研究早产儿住院时并发症较多,根据体重、身长、头围评价,出院时宫外生长发育迟缓的发生率分别为47%、29%、35%,较出生时的22%、17%、18%偏高。2.72例早产儿中随访在纠正1月后,体重、身长、头围z值平均数均-1。纠正胎龄40周时,低体重、生长迟缓、小头畸形、消瘦、超重和肥胖的生长偏离发生率分别为22%、10%、14%、7%和4%。纠正12月时低体重、生长迟缓、消瘦发生率分别为11%、22%、11%。3.按出生胎龄分组,3个组在纠正10月、12月时,34-36+6周组较32周组及32-33+6组身长较长,差异有统计学意义(p0.05);纠正1、2、3、6月的发育商(DQ)及纠正5月的粗大动作能、精细动作能、应物能的比较,32周组较其他组发育商值低,差异有统计学意义(p0.05)。4.出生体重1500g组及≥1500g组在纠正40周至8月的身长、体重、头围比较,前者三项指标落后于后者,差异有统计学意义(p0.05);出生体重1500g组在纠正1-6月的发育商及纠正7月的精细动作能落后于出生体重≥1500g组,差异有统计学意义(p0.05)。5.小于胎龄儿(SGA)与适于胎龄儿(AGA)组在纠正40周的体重、身长,纠正1、2月的体格评估及纠正3、6月的体重、头围上比较,SGA组低于AGA组,差异有统计学意义(p0.05);在纠正4月的语言能,SGA组较AGA组发育商值低,差异有统计学意义(p0.05)。6.出院时EUGR组及非EUGR组在纠正1-6月的体格评估、纠正3月的粗大动作能、纠正4月的粗大及精细动作能比较,EUGR组较非EUGR组落后,差异有统计学意义(p0.05)。结论:1.本研究早产儿纠正胎龄1岁内追赶生长时,体格生长仍有一部分处于生长落后,需积极的喂养方案以达追赶生长目标;2.出生时体重小于1500g、小于胎龄儿的早产儿在体格方面较出生体重大于1500g和适于胎龄儿的早产儿差,出院时处于EUGR对早产儿近期体格发育也有不良影响;3.本研究早产儿纠正胎龄6月内神经系统发育评价异常的比例较高,随着年龄增加,发育商DQ渐达正常。出生体重小于1500g,胎龄小于32周,出院时处于EUGR的早产儿较易发生精神运动异常,需密切随访。
[Abstract]:Objective: to follow up the physical growth and nervous system development of premature infants after discharge from hospital and analyze the risk factors of growth retardation and abnormal development of nervous system for early clinical identification. Methods: from October 2015 to December 2016, the preterm infants in the neonatal ward of the first affiliated Hospital of Guangxi Medical University were analyzed prospectively according to their birth weight. Whether the gestational age is smaller than the gestational age (SGA) and the feeding mode after discharge, and whether it is EUGRG at the time of discharge. Results: 1. In this study, the complications of premature infants in hospital were more, according to body weight, body length, head circumference evaluation. The incidence of extrauterine growth retardation at discharge was 47 / 29 / 35, which was higher than that at birth (22171718%). 2.72 premature infants were followed up after correction of January. At 40 weeks of gestational age correction, the incidence of growth deviation of low body weight, growth retardation, microcephaly, wasting, overweight and obesity were 2210% and 14%, respectively. 7% and 4.The incidence of low body weight, growth retardation and emaciation on December was 110.The incidence of low body weight, growth retardation and emaciation were 110.3. according to the birth age, the three groups were corrected on October and December. The body length of 34-36 6 week group was longer than that of 32 week group and 32 33 6 group, and the difference was statistically significant (P 0.05). The developmental quotient of 32 weeks group was lower than that of the other groups. The correction of the development quotient (DQ of June) and the correction of the coarse motor energy, fine motor energy and material response energy of May were lower than those of the other groups. The difference was statistically significant (P < 0.05). The body length, body weight and head circumference of the 1500g group and 鈮，

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