【摘要】：目的評(píng)估足月小于胎齡兒的氣質(zhì)與足月適于胎齡兒是否存在差異。如果有差異,探討這種差異與其智力及體格發(fā)育是否有關(guān)聯(lián),為足月小于胎齡兒早期的干預(yù)治療提供理論依據(jù)。方法回顧性收集2011年1月至2012年6月安徽省兒童醫(yī)院新生兒科出院的日齡在2歲到2歲零6個(gè)月之間的足月小于胎齡兒35例為病例組,并按1:1配比選取同期出生的足月適于胎齡兒為對(duì)照組。對(duì)兩組患兒分別進(jìn)行氣質(zhì)、智力及體格發(fā)育的評(píng)估;比較2組患兒氣質(zhì)、智力及體格發(fā)育的評(píng)估結(jié)果。采用自制家庭環(huán)境調(diào)查問卷收集患兒的圍產(chǎn)期及家庭相關(guān)情況。計(jì)量資料采用方差分析檢驗(yàn),計(jì)數(shù)資料采用c2檢驗(yàn),P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果1.足月小于胎齡兒中困難型、中間偏困難型和啟動(dòng)緩慢型氣質(zhì)總發(fā)生率42.86%,較足月適于胎齡兒的總發(fā)生率14.29%高(c2=7.00,P0.05);足月小于胎齡兒氣質(zhì)九維度中活動(dòng)水平(4.21±0.68)較足月適于胎齡兒(3.79±0.63)高(t=8.12,P0.05);2.足月小于胎齡兒的智力發(fā)育指數(shù)(Mental Development Index,MDI)(74.54±9.62),低于足月適于胎齡兒的MDI(88.14±8.85)(t=6.15,P0.05);運(yùn)動(dòng)發(fā)育指數(shù)(Psyehomotor Development Index PDI)(74.63±9.60),也低于足月適于胎齡兒的PDI(89.31±8.56)(t=6.76,P0.05),且智力評(píng)估80的概率高于足月適于胎齡兒,差異有統(tǒng)計(jì)學(xué)意義(c2=937,P0.05)。兩組氣質(zhì)類型為困難型、中間偏困難型和啟動(dòng)緩慢型氣質(zhì)的患兒智力指數(shù)(75.85±12.76)和運(yùn)動(dòng)指數(shù)(76.55±12.18)均要落后于容易型和中間偏容易型患兒(83.54±10.21)(t=2.65,P0.05)和(84.14±10.88)(t=2.56,P0.05),且發(fā)育商評(píng)估結(jié)果80概率高于容易型和中間偏容易型患兒(c2=3.05,P0.05)。3.足月小于胎齡兒的身高(83.03±2.13)cm低于足月適于胎齡兒(87.67±1.28)cm(t=11.03,P0.05),且在年齡2歲左右有15(42.86%)例患兒身高仍在同年齡第10個(gè)百分位以下;足月小于胎齡兒的體重(10.71±1.00)kg低于足月適于胎齡兒(12.64±1.01)kg(t=8.07,P0.05),且在年齡2歲左右有26(74.29%)例患兒體重仍在同年齡第10個(gè)百分位以下;足月小于胎齡兒的頭圍(47.32±0.43)cm低于足月適于胎齡兒(47.94±0.51)cm(t=5.51,P0.05),且在年齡2歲左右有14(40.00%)例患兒頭圍仍在同年齡第10個(gè)百分位以下;結(jié)論:1.在2歲到2歲6個(gè)月時(shí),SGA氣質(zhì)的九個(gè)維度中僅“活動(dòng)水平”低于AGA,其它維度大致相同。2.在2歲到2歲6個(gè)月時(shí),SGA出現(xiàn)困難型、中間偏困難型和啟動(dòng)緩慢型氣質(zhì)類型的概率要高于AGA。3.在2歲到2歲6個(gè)月時(shí),SGA的智力發(fā)育要明顯落后于AGA,且SGA出現(xiàn)智力缺陷的概率要明顯高于AGA。4.在2歲到2歲6個(gè)月時(shí),不論是SGA,還是AGA,氣質(zhì)類型為困難型、中間偏困難型和啟動(dòng)緩慢型的嬰兒更易出現(xiàn)智力發(fā)育的落后。5.在2歲到2歲6個(gè)月時(shí),SGA的體格發(fā)育要落后于AGA,且大多數(shù)SGA未能完全實(shí)現(xiàn)追趕性生長。
[Abstract]:Objective to evaluate the difference between term-to-term and term-appropriate gestational age in term-less-gestational infants. If there is a difference, the relationship between the difference and their intelligence and physical development is discussed, which provides a theoretical basis for the early intervention treatment of term less than gestational age infants. Methods from January 2011 to June 2012, 35 newborns aged between 2 and 2 years and 6 months of gestational age who were discharged from the pediatrics department of Anhui Children's Hospital were retrospectively collected as the case group. According to the 1:1 ratio, the full-term infants born at the same time were selected as the control group. The temperament, intelligence and physical development of the two groups were evaluated, and the results of temperament, intelligence and physical development were compared. The perinatal period and family-related situation of children were collected by self-made family environment questionnaire. Measurement data using ANOVA test, count data using c2 test, P0.05 as the difference was statistically significant. Result 1. The total rate of temperament of middle difficulty type, middle difficulty type and slow start type was 42.86%, which was higher than that of full-term infants (14.29%) (c27.00). The activity level in the nine dimensions of temperament of full-term less than gestational age infants (4.21 鹵0.68) was higher than that of full-term infants of suitable gestational age (3.79 鹵0.63) (t = 8.12 P 0.05); 2. The intelligence development index (Mental Development Index,MDI) of full-term infants less than gestational age (74.54 鹵9.62) was lower than that of full-term infants (88.14 鹵8.85) (t 6.15). The motor development index (Psyehomotor Development Index PDI) () was 74.63 鹵9.60, which was also lower than that in full-term infants (89.31 鹵8.56) (t 6.76), and the probability of intelligence evaluation was higher than that of full-term infants of suitable gestational age. The difference was statistically significant (c2 + 937). The two groups of temperament types are difficult. The intelligence index (75.85 鹵12.76) and motor index (76.55 鹵12.18) of middle difficulty and slow start temperament were lower than those of easy type and middle easy type (83.54 鹵10.21) (t = 2.65). (P 0.05) and (84.14 鹵10.88) (t 2.56 P 0.05), and the 80 probability of development quotient evaluation was higher than that of easy type and intermediate easy type (c2n 3.05 P 0.05). The height (83.03 鹵2.13) cm of full-term infants less than gestational age was lower than that of full-term infants (87.67 鹵1.28) cm (/ t 11.03). 15 cases (42.86%) were still below the 10th percentile of the same age. The body weight of full-term infants less than gestational age was (10.71 鹵1.00) kg lower than that of full-term infants with suitable gestational age (12.64 鹵1.01) kg (/ t 8.07). 26 (74.29%) of them were still below the 10th percentile of the same age. The head circumference (47.32 鹵0.43) cm of full-term infants less than gestational age was lower than that of full-term infants (47.94 鹵0.51) cm (/ t 5.51p0.05). The head circumference of 14 cases (40.00%) was still below the 10th percentile of the same age. Conclusion: 1. Between the ages of 2 and 6 months, only "activity levels" of the nine dimensions of SGA temperament were roughly the same as those of other dimensions of AGA,. At the age of 2 to 2 years and 6 months, the probability of difficulty type, middle difficulty type and slow start type of SGA was higher than that of AGA.3.. At the age of 2 to 6 months, the intellectual development of SGA was significantly lower than that of AGA, and the probability of mental retardation of SGA was significantly higher than that of AGA.4.. At the age of 2 to 6 months, whether SGA, or AGA, temperament type is difficult type, intermediate difficulty type and slow start type infants are more likely to develop mental retardation. 5. At the age of 2 to 6 months, the physical development of SGA lags behind that of AGA, and most of SGA fail to achieve catch-up growth.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R714.5

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