早期康复干预对新生儿缺氧缺血性脑病预后的影响

Effects of Early Rehabilitation on Prognostic of Newborn with Hypoxic Ischemic Encephalopathy

目的观察早期康复干预对缺氧缺血性脑病新生儿行为神经评分及智能发育商的影响。方法80例新生儿窒息合并缺氧缺血性脑病患儿随机分为早期康复组和常规治疗组各40例。早期康复组在常规治疗的基础上,根据行为神经评定量表(NB-NA)给予不同的康复干预措施。用新生儿20项行为神经评分法测定行为神经评分。随访1年,采用Gesell初评方法测试患儿动作能、应物能、应人能、言语能等4个能区的智能发育商。结果治疗后,早期康复组患儿的NBNA评分明显高于常规治疗组(P<0.01),NBNA评分≥35分的例数多于常规治疗组(P<0.05),1年后动作能、应物能、应人能、言语能4个能区的智能发育商得分提高(P<0.05)。结论早期康复干预能提高缺氧缺血性脑病新生儿的NBNA评分及1年后的智能发育商,明显改善患儿的预后。

Objective To observe the changes of neonatal behavior neurological assessment （NBNA） and one year intellectual quotient in newborn with hypoxic ischemic encephalopathy after early intervention of rehabilitation. Methods Eighty newborns with apnea combined with hypoxic ischemic eneephalopathy were divided randomly into routine group and early rehabilitation group with 40 cases in each group. Newborns in early rehabilitation group received rehabilitation treatment. All children were tested once with Chinese 20 terms NBNA before treatment and after 1 course treatment. After one-year following-up, Gesell preliminary assessment was used to test children＇s four items of intellectual development quotients, including abilities of action, responding to object, respon ding to human, and language. Results After treatment, NBNA seores of children in early rehabilitation group were significantly high er than that in routine group （ P 〈0.01）, and cases that NBNA scores over 35 in early rehabilitation group were more than that in routine group （ P 〈0. 05）. After one-year followlng-up, the scores of intellectual development quotient of children in early rehabill tation group increased significantly compared with that in routine group （ P 〈0. 05）. Conclusion Early rehabilitation can raise NBNA sores and intellectual development quotient after one year in neonate with hypoxic ischemic eneephalopathy.