本文選題：先天性心臟病 + 嬰兒��； 參考：《南京大學(xué)》2012年碩士論文

【摘要】：目的：了解先天性心臟病嬰兒術(shù)前生長發(fā)育及智力發(fā)育狀況,探討影響其生長發(fā)育和智力的相關(guān)因素。 方法： 1.研究對象為2010年8月至2011年8月期間在南京市兒童醫(yī)院心胸外科收治的符合條件的先天性心臟病嬰兒。生長發(fā)育評估共入選354例,智力評估共入選125例。 2.生長發(fā)育的評估采用Z評分法,測量患兒入院時(shí)身高、體重,計(jì)算Z值,根據(jù)Z值分為營養(yǎng)不良組及非營養(yǎng)不良組；智力的評估采用貝利嬰幼兒發(fā)展量表(BSID),根據(jù)評估結(jié)果分為正常組及異常組。 3.對研究對象的父母親進(jìn)行問卷調(diào)查,內(nèi)容包括父母職業(yè)狀況及受教育水平、妊娠狀況、母親生育年齡、出生情況、家庭環(huán)境及教育、喂養(yǎng)情況等,有無其他急慢性疾病、遺傳疾病等相關(guān)病史。 4.采用SPSS13.0統(tǒng)計(jì)軟件對數(shù)據(jù)進(jìn)行單因素及多因素分析,P0.05表示差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果： 1.生長發(fā)育結(jié)果：354例先心病嬰兒中低體重患兒108例(30.5%),經(jīng)多元回歸分析,低出生體重(OR=3.844,P=0.001)、肺動(dòng)脈高壓(OR=5.702,P=0.000)、肺炎(OR=2.161,P=0.005)具有統(tǒng)計(jì)學(xué)意義；生長遲緩患兒62例(17.5%),經(jīng)多元回歸分析,低出生體重(OR=4.137,P=0.000)、肺動(dòng)脈高壓(OR=2.352,P=0.047)、肺炎(OR=3.417,P=0.000)具有統(tǒng)計(jì)學(xué)意義；消瘦患兒95例(26.8%),經(jīng)多元回歸分析,肺動(dòng)脈高壓(OR=2.747,P=0.001)具有統(tǒng)計(jì)學(xué)意義。 2.智力結(jié)果：125例先心病嬰兒中智力落后患兒44例(35.2%),經(jīng)多元回歸分析,紫紺(OR=3.462,95%CI=1.438-8.334)具有統(tǒng)計(jì)學(xué)意義；精神運(yùn)動(dòng)落后患兒69例(55.2%),經(jīng)多元回歸分析,低出生體重(OR=6.836,95%CI=1.438-32.497)、紫紺(OR=2.498,95%CI=1.008-6.189)具有統(tǒng)計(jì)學(xué)意義。 結(jié)論：先天性心臟病嬰兒存在生長及智力發(fā)育落后。經(jīng)統(tǒng)計(jì)學(xué)分析：低出生體重、肺動(dòng)脈高壓、肺炎是先天性心臟病嬰兒生長發(fā)育的影響因素,紫紺在本研究中并未顯示出與生長發(fā)育有相關(guān)性；紫紺是先天性心臟病嬰兒智力發(fā)育的影響因素。及早手術(shù),加強(qiáng)營養(yǎng),避免反復(fù)肺炎及肺動(dòng)脈高壓的發(fā)生,盡快改善缺氧狀況,對促進(jìn)和改善先天性心臟病嬰兒的生長及智力發(fā)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 .
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R174

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