高危儿2岁时语言发育迟缓情况临床分析
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摘要
目的探讨高危儿2岁时语言发育迟缓情况,为早期诊断、早期干预,改善其预后提供科学依据。方法选择2014年6月-2015年7月在上海长海医院儿科住院治疗并随访至24月龄的64例高危儿为研究对象,以同期在儿保门诊体检的52例正常小儿为对照组,采用0～6岁儿童发育筛查测验(DST)分别在高危儿12、18、24月龄时和对照组24月龄时进行发育筛查评估。结果高危儿在24月龄时语言发育迟缓的检出率约34.4%,对照组为8.0%,差异有统计学意义(P<0.05),其中足月小样儿检出率63%最高,其次为早产儿40%,男女比例为3.4∶1。12月龄时高危儿运动发育落后和语言发育落后的检出率相差异无统计学意义(P=0.191),但18、24月龄时两者间检出率差异有统计学意义(P<0.05)。结论高危儿仍然是语言发育迟缓的高危人群,不同高危因素所致语言发育迟缓检出率不同。对高危儿需定期随访、监测和筛查语言发育,争取早发现、早干预,改善预后。
Objective To investigate the language retardation of high-risk infants at the age of 2 years,in order to provide scientific basis for early diagnosis,early intervention and improvement of prognosis. Methods A total of 64 high-risk infants were selected as participants,who received treatment and were followed up to 24 months old in Department of Pediatric in Shanghai Changhai Hospital from June 2014 to July 2015. And 52 healthy children who took physical examination in Department of Health Care were selected as control group. Developmental abilities of children were assessed by Developmental Screening Test(DST) at the age of 12 months,18 months and 24 months old in high-risk infants and at the age of 24 months old in healthy children. Results The detection rate of language retardation was about 34.4% in high-risk infants at the age of 24 months old,significantly higher than that in control group(8.0%)(P<0.05). The detection rate of full-term small-like infants was 63%,followed by 40% of the premature infants,and the ratio of male to female was 3.4∶1. No significant difference was found on the detection of dyskinesia and language retardation in high risk infants at the age of 12 months(P=0.191),and there was significant difference at the age of 18 and 24 months(P<0.05). Conclusions High-risk infants are still at high risk of language retardation,and the detection rate of language retardation caused by different factors is significantly different. Regular follow-up,monitoring and screening of language development are required for the early detection,early intervention in high-risk infants to improve the prognosis.
Objective To investigate the language retardation of high-risk infants at the age of 2 years,in order to provide scientific basis for early diagnosis,early intervention and improvement of prognosis. Methods A total of 64 high-risk infants were selected as participants,who received treatment and were followed up to 24 months old in Department of Pediatric in Shanghai Changhai Hospital from June 2014 to July 2015. And 52 healthy children who took physical examination in Department of Health Care were selected as control group. Developmental abilities of children were assessed by Developmental Screening Test(DST) at the age of 12 months,18 months and 24 months old in high-risk infants and at the age of 24 months old in healthy children. Results The detection rate of language retardation was about 34.4% in high-risk infants at the age of 24 months old,significantly higher than that in control group(8.0%)(P<0.05). The detection rate of full-term small-like infants was 63%,followed by 40% of the premature infants,and the ratio of male to female was 3.4∶1. No significant difference was found on the detection of dyskinesia and language retardation in high risk infants at the age of 12 months(P=0.191),and there was significant difference at the age of 18 and 24 months(P<0.05). Conclusions High-risk infants are still at high risk of language retardation,and the detection rate of language retardation caused by different factors is significantly different. Regular follow-up,monitoring and screening of language development are required for the early detection,early intervention in high-risk infants to improve the prognosis.
引文
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[13] 黄海燕.早产儿神经系统发育结局的研究进展[J].中国儿童保健杂志,2016,24(02):153-155.
[14] Murner-Lavanchy I,Steinlin M,Kiefer C,et al.Delayed development of neural language organization in very preterm born children[J].Dev Neuropsychol,2014,39(7):529-542.
[15] 曹敏辉,刘黎明.婴幼儿语言发育规律及研究进展[J].中国妇幼健康研究,2015,26(2):391-394.
[16] Collisson BA,Graham SA,Preston JL,et al.Risk and protective factors for late talking:an epidemiologic investigation[J].J Pediatr,2016,172:168-174.
[17] 吴莹,齐秀玉,耿胜竞.294例宫内发育迟缓儿出生2年内的身长追长观察[J].中国当代儿科杂志,2012,14(11):842-846.
[18] 徐艳红,李静,唐久来.儿童全面性发育落后的高危因素、临床特征和预后[J].中华实用儿科临床杂志,2016,31(10):783-786.
[19] 葛海静,黄敏辉,詹建英.儿童语言发育迟缓就诊延迟相关因素分析[J].中国儿童保健杂志,2016,24(3):325-328.
[2] Lawrence R,Bateman N.12 minute consultation:An evidence-based approach to the management of a child with speech and languagedelay[J].Clin Otolaryngol,2013,38(2):148-153.
[3] 万国斌.儿童语言发育障碍的筛查和鉴别[J].中国实用儿科杂志,2016,31(10):748-751.
[4] Bryan K,Garvani G,Gregory J,et al.Language difficulties and criminal justice:the need for earlier identification[J].Int J Lang Commun Disord,2015,50(6):763-775.
[5] Wallace IF,Berkman ND,Watson LR,et al.Screening for speech and language delay in children 5 years old and younger:a systematic review[J].Pediatrics,2015,136(2):e448-e462.
[6] 张瑞芳,栗新燕,范果叶,等.语言发育迟缓儿童的发育特征及相关因素分析[J].中国儿童保健杂志,2017,25(3):287-289.
[7] Reilly S,Wake M,Bavin EL,et al.Predicting language at 2 years of age:a prospective community study[J].Pediatrics,2007,120(6):e1441-e1449.
[8] Korpilahti P,Kaljonen A,Jansson-Verkasalo E.Identification of biological and environmental risk factors for language delay:The Let′s Talk STEPS study[J].Infant Behav Dev,2016,42:27-35.
[9] Takeuchi A,Yorifuji T,Takahashi K,et al.Neurodevelopment in full-term small for gestational age infants:A nationwide Japanese population-based study[J].Brain Dev,2016,38(6):529-537.
[10] Savchev S,Sanz-Cortes M,Cruz-Martinez R,et al.Neurodevelopmental outcome of full-term small-for-gestational-age infants with normal placental function[J].Ultrasound Obstet Gynecol,2013,42(2):201-206.
[11] Simic KA,Kolundzic Z,Galic S,et al.Language development in preschool children born after asymmetrical intrauterine growth retardation[J].Eur J Paediatr Neurol,2012,16(2):132-137.
[12] Zambrana IM,Vollrath ME,Sengpiel V,et al.Preterm delivery and risk for early language delays:a sibling-control cohort study[J].Int J Epidemiol,2016,45(1):151-159.
[13] 黄海燕.早产儿神经系统发育结局的研究进展[J].中国儿童保健杂志,2016,24(02):153-155.
[14] Murner-Lavanchy I,Steinlin M,Kiefer C,et al.Delayed development of neural language organization in very preterm born children[J].Dev Neuropsychol,2014,39(7):529-542.
[15] 曹敏辉,刘黎明.婴幼儿语言发育规律及研究进展[J].中国妇幼健康研究,2015,26(2):391-394.
[16] Collisson BA,Graham SA,Preston JL,et al.Risk and protective factors for late talking:an epidemiologic investigation[J].J Pediatr,2016,172:168-174.
[17] 吴莹,齐秀玉,耿胜竞.294例宫内发育迟缓儿出生2年内的身长追长观察[J].中国当代儿科杂志,2012,14(11):842-846.
[18] 徐艳红,李静,唐久来.儿童全面性发育落后的高危因素、临床特征和预后[J].中华实用儿科临床杂志,2016,31(10):783-786.
[19] 葛海静,黄敏辉,詹建英.儿童语言发育迟缓就诊延迟相关因素分析[J].中国儿童保健杂志,2016,24(3):325-328.
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