摘要
目的 探讨早期医院-家庭康复对脑损伤早产儿近期神经系统发育状况的影响.方法选择NICU生后6 h内进行aEEG检查显示脑损伤的早产儿289例,胎龄在28～36周,除外先天畸形和先天遗传代谢性疾病及新生儿期合并严重疾病.将家长不愿意参与早期干预指导者作为对照组;家长积极参与干预指导者为干预组.干预组200例,对照组89例.纠正胎龄满40周后干预组除常规体检,接受常规育儿指导外,建立系统档案监测,在医生的指导下在家中接受视、听、被动婴儿操和主动运动训练,出现异常运动者入院行系统康复训练,直到2周岁.对照组：只接受与干预组相同的常规体检和育儿指导,所有对象定期做体格、神经心理发育检查,1岁和2岁均行aEEG检查.测试者不知被测试者组别,以避免主观干扰.结果 ①两组早产儿头围、身长、体质量的体格发育在纠正胎龄6、12个月差异存在统计学意义（P〈0.05）;②两组早产儿的发育商在纠正胎龄6、9、12、18、24个月差异存在统计学意义（P〈0.05）,两组对象在不同月龄时干预组早产儿神经心理发育水平均高于对照组;③aEEG检查干预组较对照组异常率低,但脑瘫发生率虽然干预组低于对照组,但差异无统计学意义.结论 早期家庭医院-康复有助于早产儿神经系统、心理、运动系统的发育,降低脑瘫发生率,对早产儿脑损伤的恢复有积极作用.
Objective To investigate the effect of early hospital-family rehabilitation on the recent nervous system development in premature infants with brain damage. Methods A total of 289 cases of premature infants with brain injury who were born in our hospital from April 2008 to July 2010 were involved in the present study and determined by amplitude-integrated electroencephalography （aEEG） within six hours following childbirth. The gestational age ranged from 28 to 36 weeks. The premature infants with birth defects, genetic metabolic diseases and neonatal period and severe diseases were not taken into consideration. Two hundred infants were considered as an intervention group for their parents agreed to participate into the early intervention study, while 89 infants were considered as a control group for their parents had no interest in such study. In addition to the routine physical examination and care guidance, the intervention group with correct gestational age of at least 40 weeks established a monitoring file system and their listening and passive baby gymnastics were trained by doctors at home, while the abnormal ones were hospitalized for their system rehabilitation until they were 2 years old. 1-year-old and 2-year-old children underwent aEEG check. The blind test was used in the present study. Results ①The physical development indicators including the head circumfer- ence, the height, the body weight at the correction age of the 6 months and 12 months were significantly different compared to those of the con- trol group （P 〈0.05 ）. ②The premature infant＇s developmental quotient at the correction age of 6 months,9 months,12 months,18 months, and 24 months, respectively, was significantly different compared to that of the control group （ P 〈 0.05 ）. The neuropsychological development level of the intervention group in premature children was significantly higher than the control group at various months. ③The aEEG level in the intervention group was lower than that in the control group. Moreover,the incidence of cerebral palsy in the intervention group was lower than that in the control group as well, but the difference was not statistically significant. Conclusion The early Family Hospital-Rehabilita- tion is helpful in neuropsychological motion system development in premature children, which reduces the incidence of cerebral palsy and has a positive effect on the recovery of brain injury in pretenn children.
出处
《安徽医学》
2014年第1期38-41,共4页
Anhui Medical Journal
关键词
脑损伤
早产儿
早期干预
神经发育
Brain injury
Early Family Hospital-Rehabilitation
Premature children
Nervous system development
