摘要
目的探讨早期全面干预对全身运动评估异常的脑损伤高危儿神经发育的影响。方法回顾性研究2017年3月至2019年8月衡水市人民医院收治的180例早产脑损伤高危儿作为研究对象,所有研究对象经全身运动评估均存在异常。按照治疗方法将患儿分为两组:对照组和观察组,每组各90例。对照组患儿给予常规干预,观察组患儿给予早期全面干预。干预后,采用Peabody运动发育量表评价两组患儿的全身运动质量;结合焦虑自评量表与抑郁自评量表对两组患儿父母的负面情绪进行评价。结果干预后6个月,两组患儿的全身运动评估分级较干预前均有所改善,且观察组的评分(91.45±6.15)分明显优于对照组,差异均具有统计学意义(P<0.05)。干预后,观察组患儿的Peabody运动发育量表评分中的反射评分(5.79±0.64)分、固定评分(22.18±2.79)分、移动评分(34.52±3.94)分、物体控制评分(5.79±0.64)分、抓握评分(22.18±2.79)分以及视觉-运动统合评分(34.52±3.94)分显著高于对照组反射评分(4.06±0.47)分、固定评分(18.05±1.76)分、移动评分(23.18±3.05)分、物体控制评分(4.06±0.47)分、抓握评分(18.05±1.76)分以及视觉-运动统合评分(23.18±3.05)分,差异均具有统计学意义(P<0.05)。干预后12个月,观察组发生脑瘫3例、运动发育迟缓8例,明显少于对照组脑瘫6例、运动发育迟缓14例;运动发育正常79例,明显高于对照组的70例,差异均具有统计学意义(P<0.05)。干预后,观察组患儿父母的焦虑自评量表和抑郁自评量表评分为(31.29±3.87)分、(36.83±4.52)均低于对照组(48.63±6.12)分、(51.25±5.47)分,差异具有统计学意义(P<0.05)。结论早期全面干预可有效促进全身运动评估异常脑损伤高危儿的神经发育,疏导患儿父母负面情绪,在促进患儿康复及家庭和谐方面均有积极作用,值得推广应用。
Objective To explore the effect of general movements evaluation on the neurological development in high risk infants with brain injury.Methods A retrospective study was conducted on 180 infants at high risk of premature brain injury admitted in our hospital from March 2017 to August 2019.All the subjects were evaluated as abnormal by general movements evaluation.According to the random number table method,the children were divided into two groups:the control group and the observation group,with 90 cases in each group.The control group was given routine intervention;the observation group was given early comprehensive intervention.After intervention,the Peabody developmental motor scales were used to evaluate the general movements quality in the two groups.The negative emotions of the parents of the two groups were evaluated by the self-rating anxiety scale and the self-rating depression scale.Results Six months after the intervention,the scales of general movements evaluation were improved in both groups compared with those before the intervention,and the scale of the observation group(91.45±6.15)was significantly better than that of the control group(P<0.05).After the intervention,the reflexes score,stationary score,locomotion score,object manipulation score,grasping score and visual-motor integration score in the Peabody developmental motor scales of the observation group were significantly higher those of the control group(5.79±0.64 vs.4.06±0.47;22.18±2.79 vs.18.05±1.76;34.52±3.94 vs.23.18±3.05;5.79±0.64 vs.4.06±0.47;22.18±2.79 vs.18.05±1.76;34.52±3.94 vs.23.18±3.05,respectively),and the differences were statistically significant(P<0.05).12 months after intervention,cases of cerebral palsy and motor retardation were less in the observation group than in the control group(3 vs.6,8 vs.14,respectively);while cases of normal motor development were significantly more than in the control group(79 vs.70,P<0.05).After the intervention,the scores of anxiety self-rating scale and depression self-rating scale of the parents in the observation group were lower than those in the control group(31.29±3.87 vs.48.63±6.12 and 36.83±4.52 vs.51.25±5.47,respectively,P<0.05).Conclusion Early comprehensive intervention can effectively promote neurological development in high risk infants with brain injury and with abnormal general movements evaluation,relieve the parents'negative emotions,and play a positive role in promoting children's rehabilitation and family harmony.It is worth promoting and applying.
作者
张九菊
梁丽霞
袁志忠
刘义粉
李洋
崔彦存
杜桂梅
杜晓宁
孙海英
刘燕
刘金和
ZHANG Jiu-ju;LIANG Li-xia;YUAN Zhi-zhong(Department of Neonatology,Hengshui People's Hospital,Hengshui Hebei 053000,China;Department of Clinical Laboratory,Hengshui Fourth People's Hospital,Hengshui Hebei 053000,China)
出处
《临床和实验医学杂志》
2020年第10期1113-1117,共5页
Journal of Clinical and Experimental Medicine
基金
河北省卫生和计划生育委员会课题项目(编号:2016014104Z)。
关键词
脑损伤高危儿
全身运动评估异常
早期全面干预
神经发育
负面情绪
High risk children of brain injury
Abnormal general movements evaluation
Early comprehensive intervention
Neurological development
Negative emotions
