中文摘要：

目的 观察极低出生体重儿（VLBWI）和极早早产儿（VPI）神经发育预后及影响因素,探讨早期干预对其神经发育预后的影响.方法 对VPI和VLBWI早产儿114例进行出院后的干预和随访,在纠正年龄1岁时进行智能发育测试（CDCC）.根据CDCC结果将114例患儿分为智力发育正常组[智力发育指数（MDI）≥80分]和异常组（MDI＜ 80分）以及运动发育正常组[运动发育指数（PDI）≥80分]和异常组（PDI＜ 80分）.对高危因素进行Logistic回归分析.同时根据有无进行干预分为干预组和无干预组,分析其对早产儿神经发育预后的影响.结果 MDI正常组的男、女性早产儿比例、窒息和低体温发生率、胎教以及父母对早期教育认识等与MDI异常组比较,差异均有统计学意义（P＜0.05）;PDI正常组胎龄、窒息、HIE和颅内出血发生率、父亲学历、胎教、干预与PDI异常组比较,差异均有统计学意义（P＜0.05）.干预组PDI和MDI评分分别为（97.40 ±21.07）分和（96.15±18.10）分,与无干预组的（81.70±21.69）分和（91.35±19.24）分比较,组间差异均有统计学意义（P＜0.05）.干预组的PDI异常例数、20项结果异常例数以及脑瘫发生例数与无干预组比较,组间差异均有统计学意义（P＜0.05）.经Logistic回归分析发现,窒息是影响MDI和PDI预后的危险因素,缺血缺氧性脑病是影响PDI预后的危险因素,父母对孩子早期教育的重视是MDI预后的保护因素,且积极干预亦是影响PDI预后的保护因素.结论 VPI和VLBWI的神经发育异常率高,减少围产期窒息的发生,提高父母对早期教育的重视程度,同时给予积极干预可改善其预后.

英文摘要：

Objective To investigate the neurodevelopment of very low birth weight （VLBWI） and very preterm infants （VPI） and the factors influencing that development,especially the effect of early intervention.Methods Early intervention and follow-up visits were performed on 114 VPIs and VLBWIs after their discharge from the neonatal NICU.The infants were classified into an intervention group and a non-intervention group,based on whether the parents had performed early family intervention or not.The infants received the infant Developmental test of Children＆#39;s Center of China （CDCC） at 1 year old.According to the test results,they were divided into a normal mental development index （MDI） group,an abnormal MDI group,a normal psychomotor development index （PDI）group and an abnormal PDI group.A 20-item neurological movement scale was also used to assess the subjects.Potential high-risk factors were sought using Logistic regression.Results Significant differences between the normal and abnormal MDI groups were observed in terms of the male/female ratio,the incidence of asphyxia and hypothermia,antenatal training and the intensity of their early education （P 〈 0.05）.There were also significant differences between the normal and abnormal PDI groups in terms of gestational age and the incidence of asphyxia,hypoxic-ischemic encephalopathy and intracranial hemorrhage （P 〈 0.05）.The fathers＆#39; education level,antenatal training and the frequency of intervention also predicted PDI scores.The average PDI and MDI score of the intervention group was 97.40 ± 21.07 and 96.15 ± 18.10,and those of the non-intervention group were 81.70 ± 21.69 and 91.35 ± 19.24,both with significant difference between the two groups （P 〈 0.05）.In the intervention group significantly fewer infants had abnormal PDI scores,with abnormal results of the 20-item scale or cerebral palsy （P 〈 0.05）.The regression results suggest that asphyxia and hypoxic-ischemic encephalopathy are risk factors for poor mental