《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (06): 677-682.

• 特稿 • 上一篇    下一篇

早期干预对呼吸衰竭早产儿脑损伤的疗效评价

任青，王金慎，张勇军，杨巧芝   

  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-06-25 发布日期:2015-06-25

Effects of Early Intervention on Brain Injury in Premature Infants with Neonate Respiratory Failure

REN Qing, WANG Jin-shen, ZHANG Yong-jun, YANG Qiao-zhi   

  1. Department of Pediatrics, Liaocheng People's Hospital, Liaocheng, Shandong 252000, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-06-25 Online:2015-06-25

PDF (PC)

被引次数

18

摘要： 目的 探讨早期康复干预治疗对呼吸衰竭早产儿脑损伤预后的影响。方法 选取本院新生儿重症监护室(NICU)生后24 h内入院即诊断为呼吸衰竭(NRF)的早产儿共151例，均行气管插管机械通气，且并发早产儿脑损伤。按入院时间和家长意愿分为常规组(n=71)和干预组(n=80)。两组患儿均接受常规保健指导；干预组住院病情稳定后接受抚触、被动操及听、视、触觉刺激。并于出院后给予干预组主动运动训练及家庭干预。两组患儿均在纠正年龄40周行NBNA评分，3、6月龄时采用婴儿神经系统国际测验量表(Infanib)进行早期运动发育评估，6、12、18个月时采用中国科学院心理研究所和中国儿童发展中心(CDCC)婴幼儿智能发育量表对其进行智力指数测定，18个月时采用 Gesell发育诊断量表评分。结果 两组 40周时 NBNA评分无显著性差异(P>0.05)。呼吸衰竭早产儿于 3月龄、6月龄时进行 Infanib评估，干预组正常的比例均高于常规组(P<0.05)。干预组生后 6、12、18个月时CDCC的智力发育指数(MDI)和心理运动发育指数(PDI)得分均显著高于常规组(P<0.001)。18月龄时，干预组 Gesell发育诊断量表的大运动、精细动作，以及适应性、语言、社会交往能力得分都显著高于常规组(P<0.001)。干预组后遗症的发生率为 12.5%，低于常规组的25.4%(P<0.05)。结论 早期康复干预对智力和运动发育起促进作用，可改善呼吸衰竭早产儿脑损伤的预后。

关键词: 早产儿, 新生儿呼吸衰竭, 脑损伤, 康复, 早期干预

Abstract: Objective To explore the effects of early intervention on brain injury in premature infants with neonate respiratory failure (NRF). Methods 151 premature infants in neonatal intensive care unit (NICU) who were diagnosed as NRF within 24 hours after birth in our hospital were studied. All of them accepted endotracheal intubation and mechanical ventilation, and were complicated with brain injury. According to their admission date and their parents' desire, these premature infants were divided into routine group (n=71) and intervention group (n=80). Both 2 groups received similar routine care, and the intervention group accepted touching, passive exercise and stimulation of hearing, vision and touch in addition. Active motor training and family intervention were also given to the intervention group after discharge. They were assessed with Neonatal Behavioral Neurological Assessment (NBNA) at the corrected age of 40 weeks, Infant Neurological International Battery (Infanib) at the corrected age of 3 and 6 months, mental development index (MDI) and psychomotor development index (PDI) at the corrected age of 6, 12 and 18 months, Gesell Development Schedules at the corrected age of 18 months. Results There was no significant difference in NBNA score between 2 groups at 40 weeks of gestational age (P>0.05). The percentage of normal ones with Infanib was higher in the intervention group than in the routine group at the age of 3 and 6 months (P<0.05). The MDI and PDI were significantly higher in the intervention group than in the routine group at the age of 6, 12 and 18 months (P<0.001). The scores of gross motor, fine motor, adaptation, language and social skills were significantly higher in the intervention group than in the routine group at the age of 18 months (P<0.001). The incidence of sequelae was lower in the intervention group (12.5%) than in the routine group (25.4%) (P<0.05). Conclusion Early intervention can promote the intelligence and motor development, and improve the outcome of brain injury in the premature infants with NRF.

Key words: premature infant, neonate respiratory failure, brain injury, rehabilitation, early intervention