先天性心脏病婴儿生长及智力发育状况的研究

发布时间：2018-06-21 19:47

本文选题：先天性心脏病 + 婴儿　；参考：《南京大学》2012年硕士论文

【摘要】：目的：了解先天性心脏病婴儿术前生长发育及智力发育状况,探讨影响其生长发育和智力的相关因素。方法： 1.研究对象为2010年8月至2011年8月期间在南京市儿童医院心胸外科收治的符合条件的先天性心脏病婴儿。生长发育评估共入选354例,智力评估共入选125例。 2.生长发育的评估采用Z评分法,测量患儿入院时身高、体重,计算Z值,根据Z值分为营养不良组及非营养不良组；智力的评估采用贝利婴幼儿发展量表(BSID),根据评估结果分为正常组及异常组。 3.对研究对象的父母亲进行问卷调查,内容包括父母职业状况及受教育水平、妊娠状况、母亲生育年龄、出生情况、家庭环境及教育、喂养情况等,有无其他急慢性疾病、遗传疾病等相关病史。 4.采用SPSS13.0统计软件对数据进行单因素及多因素分析,P0.05表示差异有统计学意义。结果： 1.生长发育结果：354例先心病婴儿中低体重患儿108例(30.5%),经多元回归分析,低出生体重(OR=3.844,P=0.001)、肺动脉高压(OR=5.702,P=0.000)、肺炎(OR=2.161,P=0.005)具有统计学意义；生长迟缓患儿62例(17.5%),经多元回归分析,低出生体重(OR=4.137,P=0.000)、肺动脉高压(OR=2.352,P=0.047)、肺炎(OR=3.417,P=0.000)具有统计学意义；消瘦患儿95例(26.8%),经多元回归分析,肺动脉高压(OR=2.747,P=0.001)具有统计学意义。 2.智力结果：125例先心病婴儿中智力落后患儿44例(35.2%),经多元回归分析,紫绀(OR=3.462,95%CI=1.438-8.334)具有统计学意义；精神运动落后患儿69例(55.2%),经多元回归分析,低出生体重(OR=6.836,95%CI=1.438-32.497)、紫绀(OR=2.498,95%CI=1.008-6.189)具有统计学意义。结论：先天性心脏病婴儿存在生长及智力发育落后。经统计学分析：低出生体重、肺动脉高压、肺炎是先天性心脏病婴儿生长发育的影响因素,紫绀在本研究中并未显示出与生长发育有相关性；紫绀是先天性心脏病婴儿智力发育的影响因素。及早手术,加强营养,避免反复肺炎及肺动脉高压的发生,尽快改善缺氧状况,对促进和改善先天性心脏病婴儿的生长及智力发展有重要作用。
[Abstract]:Objective : To investigate the growth and development of congenital heart disease infants before operation and to explore the factors affecting their development and intelligence .

Method :

1 . A total of 354 cases of congenital heart disease were selected from Aug . 2010 to Aug . 2011 in Children ' s Hospital of Nanjing .

2 . The Z - score method was used to measure the height , weight and Z - value of children ' s admission , and divided into malnutrition group and non - malnutrition group according to the Z - value .
The evaluation of intelligence is based on BSID , which is divided into normal group and abnormal group according to the evaluation result .

3 . The parents of the research object were investigated by questionnaire , including the professional status of parents and the educational level , the pregnancy status , the mother ' s reproductive age , the birth situation , the family environment and education , the feeding situation , etc . , whether there were other relevant medical history such as acute and chronic diseases and genetic diseases .

4 . SPSS 13.0 software was used to analyze the single factor and multivariate analysis of the data , and the difference was statistically significant .

Results :

1 . Growth and development results : Among 354 infants with congenital heart disease , 108 cases ( 30.5 % ) had low birth weight ( OR = 3.844 , P = 0.001 ) , pulmonary hypertension ( OR = 5.702 , P = 0.000 ) , pneumonia ( OR = 2.161 , P = 0.005 ) .
There were 62 cases ( 17.5 % ) of children with growth retardation , multivariate regression analysis , low birth weight ( OR = 4.137 , P = 0.000 ) , pulmonary hypertension ( OR = 2.352 , P = 0.047 ) , pneumonia ( OR = 3.417 , P = 0.000 ) .
95 cases ( 26 . 8 % ) of children with wasting were statistically significant by multivariate regression analysis and pulmonary hypertension ( OR = 2.747 , P = 0.001 ) .

2 . Intelligence results : Among 125 infants with congenital heart disease , 44 ( 35 . 2 % ) of children with mental retardation had statistical significance by multivariate regression analysis , cyanosis ( OR = 3.462 , 95 % CI = 1.438 - 8.334 ) ;
69 cases ( 55.2 % ) of children with mental retardation were statistically significant by multivariate regression analysis , low birth weight ( OR = 6.836 , 95 % CI = 1.438 - 32.497 ) , cyanosis ( OR = 2.498 , 95 % CI = 1.008 - 6.189 ) .

Conclusion : There is a lag in growth and intelligence development in infants with congenital heart disease . Statistical analysis shows that low birth weight , pulmonary hypertension and pneumonia are the factors affecting the growth and development of infants with congenital heart disease .
cyanosis is an important factor in the intelligence development of infants with congenital heart disease . Early operation , strengthening nutrition , avoiding recurrent pneumonia and pulmonary hypertension , improving hypoxia condition as soon as possible , plays an important role in promoting and improving the growth and intelligence development of infants with congenital heart disease .
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R174

【参考文献】