本文關(guān)鍵詞： 早產(chǎn)兒 出院后 生長發(fā)育 神經(jīng)發(fā)育　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:隨訪早產(chǎn)兒出院后體格生長及神經(jīng)系統(tǒng)發(fā)育的情況,分析生長發(fā)育遲緩及神經(jīng)系統(tǒng)發(fā)育異常的危險(xiǎn)因素,為臨床早期識(shí)別、合理干預(yù)治療提供理論參考。方法:前瞻性分析2015年10月至2016年12月廣西醫(yī)科大學(xué)第一附屬醫(yī)院新生兒病房住院的早產(chǎn)兒,并根據(jù)出生體重、胎齡、是否小于胎齡兒(SGA)和出院后喂養(yǎng)方式、出院時(shí)是否為宮外生長發(fā)育遲緩(EUGR)分組,比較出院后體格生長及神經(jīng)發(fā)育情況。結(jié)果:1.本研究早產(chǎn)兒住院時(shí)并發(fā)癥較多,根據(jù)體重、身長、頭圍評(píng)價(jià),出院時(shí)宮外生長發(fā)育遲緩的發(fā)生率分別為47%、29%、35%,較出生時(shí)的22%、17%、18%偏高。2.72例早產(chǎn)兒中隨訪在糾正1月后,體重、身長、頭圍z值平均數(shù)均-1。糾正胎齡40周時(shí),低體重、生長遲緩、小頭畸形、消瘦、超重和肥胖的生長偏離發(fā)生率分別為22%、10%、14%、7%和4%。糾正12月時(shí)低體重、生長遲緩、消瘦發(fā)生率分別為11%、22%、11%。3.按出生胎齡分組,3個(gè)組在糾正10月、12月時(shí),34-36+6周組較32周組及32-33+6組身長較長,差異有統(tǒng)計(jì)學(xué)意義(p0.05);糾正1、2、3、6月的發(fā)育商(DQ)及糾正5月的粗大動(dòng)作能、精細(xì)動(dòng)作能、應(yīng)物能的比較,32周組較其他組發(fā)育商值低,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。4.出生體重1500g組及≥1500g組在糾正40周至8月的身長、體重、頭圍比較,前者三項(xiàng)指標(biāo)落后于后者,差異有統(tǒng)計(jì)學(xué)意義(p0.05);出生體重1500g組在糾正1-6月的發(fā)育商及糾正7月的精細(xì)動(dòng)作能落后于出生體重≥1500g組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。5.小于胎齡兒(SGA)與適于胎齡兒(AGA)組在糾正40周的體重、身長,糾正1、2月的體格評(píng)估及糾正3、6月的體重、頭圍上比較,SGA組低于AGA組,差異有統(tǒng)計(jì)學(xué)意義(p0.05);在糾正4月的語言能,SGA組較AGA組發(fā)育商值低,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。6.出院時(shí)EUGR組及非EUGR組在糾正1-6月的體格評(píng)估、糾正3月的粗大動(dòng)作能、糾正4月的粗大及精細(xì)動(dòng)作能比較,EUGR組較非EUGR組落后,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:1.本研究早產(chǎn)兒糾正胎齡1歲內(nèi)追趕生長時(shí),體格生長仍有一部分處于生長落后,需積極的喂養(yǎng)方案以達(dá)追趕生長目標(biāo);2.出生時(shí)體重小于1500g、小于胎齡兒的早產(chǎn)兒在體格方面較出生體重大于1500g和適于胎齡兒的早產(chǎn)兒差,出院時(shí)處于EUGR對(duì)早產(chǎn)兒近期體格發(fā)育也有不良影響;3.本研究早產(chǎn)兒糾正胎齡6月內(nèi)神經(jīng)系統(tǒng)發(fā)育評(píng)價(jià)異常的比例較高,隨著年齡增加,發(fā)育商DQ漸達(dá)正常。出生體重小于1500g,胎齡小于32周,出院時(shí)處于EUGR的早產(chǎn)兒較易發(fā)生精神運(yùn)動(dòng)異常,需密切隨訪。
[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，

本文編號(hào)：1465781