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我们应该对哪些高危婴儿进行随访,以及应该如何进行随访?

Which high-risk infants should we follow-up and how should we do it?

作者信息

Walker Karen, Holland Andrew J A, Halliday Robert, Badawi Nadia

机构信息

Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

J Paediatr Child Health. 2012 Sep;48(9):789-93. doi: 10.1111/j.1440-1754.2012.02540.x.

Abstract

Early detection of neurodevelopmental delay and appropriate intervention has been associated with improved academic and social outcomes. Identifying those who are at high risk and might benefit is not straightforward. Approximately 2% of infants are admitted to a neonatal intensive care unit after birth and these babies are known to be at high risk of developmental impairment. While it is well recognised that the extreme preterm infant is at high risk of developmental impairment, there is increasing evidence of a risk in late preterm infants as well as those undergoing major cardiac and non-cardiac surgery. Not all infants are enrolled in multidisciplinary follow-up clinics with easy access to early intervention. These clinics are expensive to run with both limited and conflicting data on their long-term value. This review will concentrate on identifying which infants are at risk, reviewing the aetiology of the risk factors and the efficacy of follow-up clinics.

摘要

神经发育迟缓的早期检测和适当干预与学业和社会成果的改善相关。识别那些高危且可能受益的人群并非易事。大约2%的婴儿出生后会被送入新生儿重症监护病房,这些婴儿已知有发育障碍的高风险。虽然人们普遍认识到极早产儿有发育障碍的高风险,但越来越多的证据表明晚期早产儿以及接受重大心脏和非心脏手术的婴儿也存在风险。并非所有婴儿都参加了能方便获得早期干预的多学科随访诊所。这些诊所运营成本高昂,且关于其长期价值的数据有限且相互矛盾。本综述将专注于确定哪些婴儿有风险,回顾风险因素的病因以及随访诊所的疗效。

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