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目的分析全面性发育迟缓(GDD)患儿的主要病因和早期综合干预疗效,以及判断其神经行为发育预后情况。方法 33例住院进行综合性干预的GDD患儿为综合干预组,31例未住院进行综合性干预,仅指导家庭干预的患儿为对照组。分析其病因,结合不同病因设计个体治疗方案,并在干预前后应用GESELL发育量表测定发育商(DQ)进行统计分析,评价疗效。结果治疗干预前,两组患儿一般情况差异无统计学意义,6个月后综合干预组患儿DQ为(72.20±15.56),明显高于治疗前的(59.98±14.61)和对照组的(62.51±13.95),干预组疗效评估亦明显优于对照组,差异有统计学意义(P均<0.05)。新生儿HIE、早产、宫内发育迟缓和新生儿窒息是GDD的常见病因。单致病因素所致GDD患儿的DQ发育优于多致病因素GDD患儿。结论综合性早期干预,结合病因设计个体治疗方案可明显提高GDD患儿的DQ,改善其预后。加强围生期保健,对防治GDD具有重要的意义。
Objective To analyze the main etiopathogenisis of children with generalized developmental delay (GDD) and the effect of early comprehensive intervention and to determine the prognosis of neurobehavioral development. Methods A total of 33 children with GDD admitted to hospital for comprehensive intervention were comprehensive intervention group, 31 patients were not hospitalized for comprehensive intervention, and only those children who instructed family intervention were taken as control group. Analyze its etiology, design the individual treatment plan according to different etiology, and use the GESELL developmental scale to measure the developmental quotient (DQ) before and after the intervention for statistical analysis to evaluate the curative effect. Results Before treatment intervention, there was no significant difference in the general situation between the two groups. After 6 months, the DQ in the comprehensive intervention group was (72.20 ± 15.56), significantly higher than that before treatment (59.98 ± 14.61) and in the control group 62.51 ± 13.95). The therapeutic effect in the intervention group was also significantly better than that in the control group, with significant difference (all P <0.05). Neonatal HIE, premature birth, intrauterine growth retardation and neonatal asphyxia are common causes of GDD. DQ development in children with GDD due to single disease is superior to that in children with multidrug-causing disease. Conclusion Comprehensive early intervention combined with etiological design of individual treatment programs can significantly improve the DQ in children with GDD and improve their prognosis. Strengthening perinatal health care is of great significance for the prevention and control of GDD.