超早期干预对新生儿缺氧缺血性脑病患儿预后影响的研究

Study on the Effects of Early Intervention on Prognosis of Newborn Hypoxic-ischemic Encephalopathy

目的探讨超早期干预对新生儿缺氧缺血性脑病患儿脑瘫及智能发育障碍的影响。方法将216例高危新生儿分为两组,干预组130例,除常规治疗外,施行早期环境干预和康复功能训练,依据0～3岁小儿智能发育规律及教育大纲,随访干预治疗至18个月龄;对照组86例,只接受常规治疗及常规育儿指导和评估。结果干预组神经行为评分第28天明显高于对照组(P<0.001);两组在18个月龄的智力发育指数(MDI),运动发育指数(PDI)干预组明显高于对照组(P<0.001);两组发育落后及后遗症发生率,干预组明显低于对照组(P<0.05)。结论早期环境干预、系统的康复功能训练,以及足够的治疗疗程和随访可降低新生儿缺氧缺血性脑病脑瘫和智能低下的发生率,提高其存活质量。

Objective To detect the effects of early intervention on cerebral palsy of newborn hypoxic-ischemic en- cephalopathy and the obstacles to intellectual development. Methods 216 cases of high-risk newborns were divided into two groups.The intervention group included 130 cases,in which the newborns accepted early environmental intervention and func- tional recuperation training,besides some conventional treatments.And they were followed up till 18 months old according to the law of intellectual development and the educational syllabus for babies aged 0～3 years.The control group included 86 newborns, in which the babies only received conventional treatments and baby-raising instructions and assessment.Results The neu- robehavior score in the intervention group was much higher than that of the control group on the 28th day (P<0.001).The men- tal development index (MDI) and the psychomotive development index (PDI) at 18 months in the intervention group were much higher than those of the control group (P<0.001).While the sequela incidence and slow development of the intervention group were obviously lower than that in the control group (P<0.05).Conclusion Early environmental intervention, systematic functional recuperation training,efficient courses of physiotherapy and follow -up can reduce the incidence of newborn hypoxic ischemic encephalopathy and low intelligence,and also can improve the babies' life quality.