摘要
【目的】评价早期干预对防治围产期高危儿神经系统发育异常的临床价值。【方法】采用自身前后对照的方法,将106例围生期高危儿及10例足月健康新生儿分别分成早期干预组(A组:新生儿早期干预组58例;B组:婴儿期早期干预组41例)、非早期干预组(C组:1岁以后干预组7例)、正常新生儿对照组(D组10例)。干预组(A组、B组、C组)各自采用不同的针对性训练和康复方法进行干预;正常新生儿接受常规的健康训练和指导。新生儿期患儿在生后1周、4周各检查评估1次(采用20项神经行为测定法NBNA法);婴儿期患儿每月随访1次(52项神经运动检查法)。【结果】A组患儿生后4周NBNA评分明显高于生后1周时评分(P<0.01);只有单一高危因素的新生儿与D组新生儿的NBNA评分比较差异无显著性(P>0.05);两组大运动发育检查发现A组与D组评分差距随年龄的增长迅速缩小,与B组和C组相比差异无显著性(P>0.05)。B组患儿干预效果经随诊检查发现低于A组;C组患儿干预效果不佳(7例患儿中3例确诊为脑性瘫痪,其余4例都存在严重的运动落后)。D组正常新生儿生后1、4周时NBNA评分差异无显著性(P>0.05)。【结论】早期干预措施对围生期高危儿有促进正常神经系统发育以及脑损伤后早期康复的作用,且干预开始越早效果越好。
[Objective] To evaluate clinic value of early intervention in high-risk infants with abnormal nervous system development. [Methods] Self-control method was used. The 106 high-risk infants and 10 mature healthy infants were divided into A.B. C and D groups：A group were early intervention of newborns（n = 58 ） ;B group were intervention of infants（n = 41 ） ;C group were nor-early intervention children（n = 7 ） ; D group were healthy babies（n = 101. Deferent treatment and intervention were made in these high-risk infants during their neonatal period and babyhood. The normal babies just accepted general training and guiding. Neonates were checked at the first week and the fourth week by NBNA. Babies were checked monthly by 52 neuro motorial examination. In addition, physique development was checked. [Results] Group A ：the NBNA score at the fourth week increased than at one week significantly（P〈0.01 ）,and the score of infants with unity high-risk factors were no difference significantly compared to Multiple one（P〉 0.05 ）;the disparity of NBNA score between group A and group D were shorten significantly at motor development as the age increased. There were significantly difference among the group A ,group B and group C （P〈0. 05）. The interventire results of group B infants were inferior to group A, and group C was worse mostly（three of them were diagnosed CP,and four of them had significant redardation in motor development）. The NBNA score of group D infants was no significant deference between first week and fourth week（P〉 0. 05）. [Conclusion] Early intervention in high-risk infants are helpful to improve development of physique and nervous system, and the improvement would be more evident if the intervention began earlier.
出处
《中国儿童保健杂志》
CAS
2006年第1期6-8,共3页
Chinese Journal of Child Health Care
基金
北京市自然科学基金(7053080)
关键词
高危儿
早期干预
脑损伤
新生儿
婴儿
high-risk
early intervention
cerebal injure
neonate
infant
