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摘要


近年來,高危險性早產兒的存活率因新生兒科醫療技術的進步而大為提高,但因合併極度早產及其他諸多危險因子,日後產生發育遲緩、學習障礙、心理及行為等問題之機會較一般足月正常之嬰兒為高。本著早期發現、早期治療的原則,榮民總醫院復健醫學部自79年10月起,與新生兒科合作,於小兒加護病房及病嬰室,針對早產兒群,尤其是合併下列一或多項危險因子,如出生體重小於1500g 、懷孕週數低於32週、長期倚賴呼吸器、第三或四度顱內出血、肌肉張力異常、抽筋、餵食困難及窒息等之早產兒進行早期介入治療。內容視個別需要,包括治療性擺位、治療性運動、餵食及口腔功能治療、家屬教育。並在實足年齡(chronologic age)達36週之早產兒,施以Morgan神經行為量表(Morgan neurobehavior scale)檢查,以視其中樞神經系統發展之成熟度及穩定性。出院後,定期於矯正年齡(correcled age)四個月、八個月、十二個月作發育之追蹤及篩選,除詳細之神經檢查外,使用之評估工具包括嬰兒動作評估(movement assessment of infant),貝利嬰幼兒發展量表(Bayley scale of infant development),丹佛發展篩選量表(Denver developmental screening test)。任何時候發現有神經及發展方面之異常,即馬上開始神經發展治療(neurodevelopmental treatment),以期使該問題之影響降至最低。隨後並將逐年追蹤至學齡時期為止。

並列摘要


The survival rate of high-risk premature baby is increasing in recent years because of improvement in medical technology for newborn care. Unfortunately, since many of them were born with one or some risk factors, the incidence to complicate with developmental disability, learning disability, emotional or behavior problems will be higher than general population. We started early intervention program for the prematurity in PICU and SBR in Oct., 1990 especially for those high-risk prematurity who combined with one or more risk factors as below: birth weight less than 1500 gm, gestational age below 32 weeks, ventilator requirment, grade III or IV intracranial hemorrhage, abnormal muscle tone, seizure disorder, feeding dysfunction and neonatal asphyxia. Intervention program is individualized which includes therapeutic postioning, therapeutic handling, oral-motor therapy and parent education. Also, Morgan neurobehavior scale will be performed in medically stable premature baby to see the maturation and stability of central nervous system. Developemtnal screening and follow-up will be done at four, eight and twelve months old corrected age after discharge. Besides from detailed neurologic examination, movement assessment of infant, Bayley scale of infant development and Denver developmental screening teat are used to detect developmental disability during infancy. The baby will receive neurodevelopmental therapy immediately if there is any sign of developmental abnormality. Afterwards, yearly follow-up will be arranged until they reach school age and are doing well at school.

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被引用紀錄


鍾采玲(2013)。托嬰中心托育模式對嬰幼兒發展影響之研究〔碩士論文,朝陽科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0078-2712201314041749

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