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目的探讨社区干预对高危儿体格和智力发育的影响。方法抽取济南市2009年1—12月出生且筛查出的高危儿340例,随机分为干预组177例和对照组163例。干预组对高危儿定期进行监测随访,根据每次的评估结果制定不同的干预方案;对照组接受日常保健管理,进行喂养、营养的指导和体格发育检查,未进行系统干预。结果除6个月身长、18个月头围外,两组不同年龄体重、头围、身长比较差异均有统计学意义(均P<0.05)。42 d两组各发育商数(developmental quotient,DQ)评分比较差异均无统计学意义(均P>0.05),其余年龄两组DQ评分比较差异均有统计学意义(均P<0.05)。6、9、12个月DQ异常率干预组分别为25.4%、6.2%、0.5%,与对照组比较差异均有统计学意义(均P<0.05)。3、6、9、12个月肌张力异常率干预组分别为38.9%、25.4%、6.2%、0.5%,与对照组比较差异均有统计学意义(均P<0.05)。3、6、9、12个月姿势异常率干预组分别为4.5%、1.7%、0、0,与对照组比较差异均有统计学意义(均P<0.05)。结论社区干预可促进高危儿的体格和智力发育,减少脑瘫等的发生。
Objective To explore the impact of community intervention on the physical and mental development of high-risk infants. Methods A total of 340 high risk infants who were born and screened from January to December in 2009 in Jinan were randomly divided into intervention group (n = 177) and control group (n = 163). The intervention group regularly monitored and followed up the high-risk infants, and formulated different intervention plans according to the results of each evaluation. The control group received routine health care, feeding, nutrition guidance and physical development examination without systematic intervention. Results Except 6 months old and 18 months old, the weight, head circumference and body length of two groups were significantly different (all P <0.05). There was no significant difference in the scores of developmental quotient (DQ) between the two groups on the 42nd day (all P> 0.05). There were significant differences in DQ scores between the two groups (all P <0.05). At 6, 9 and 12 months, the rates of abnormal DQ in intervention group were 25.4%, 6.2% and 0.5%, respectively, which were significantly different from those in control group (all P <0.05). The rates of abnormal muscle tone at 3, 6, 9 and 12 months in intervention group were 38.9%, 25.4%, 6.2% and 0.5%, respectively, which were significantly different from those in control group (all P <0.05). The postoperative gestational abnormalities at 3, 6, 9 and 12 months were 4.5%, 1.7% and 0%, respectively, which were significantly different from the control group (all P <0.05). Conclusion Community intervention can promote high-risk children’s physical and mental development, reduce the occurrence of cerebral palsy.