早期干预对脑瘫高危患儿预后影响的临床研究

The clinical study of the early intervention in cerebral Pasly high-risk inafnts

目的探讨小儿神经发育学评估方法对脑瘫高危儿早期神经行为异常评定的应用价值,并评价早期干预的疗效。方法高危新生儿共151例,其中干预组90例,非干预组61例。干预方法采用家庭与门诊相结合的干预模式,并根据神经发育学评估结果结合Vojta诱导疗法、Bobath法肢体功能训练法进行个别强化训练。两组儿童均接受常规育儿指导。神经发育检测方法采用Vojta姿势反射、52项神经运动检查、Gesell婴幼儿发育检查量表评价。结果 6、12月龄干预组Vojta、52项检查异常率较非干预组为低(P<0.01),Gesell发育评价(DQ)在6、12、18月龄时干预组各能区DQ高于非干预组(P<0.01)。结论早期个体化的综合干预能有效地改善高危儿的神经发育水平,促进智力及运动发育,降低脑瘫发生率,干预越早效果越好。

Objective： To study the value of neurobehavior test in predicting the damage in neurological function of infants with cerebral Pasly high-risk infants and the effect of early intervention. Method： Subjects of the study included 151 cases of newborns with middle and serious HIE and premature infants, among whom 90 infants were divided into the early intervention group, and 61 cases were in the non-intervention group. The intervention pattern of the combination of family and the clinic was used. Vojta inducement training and Bobath limb function training were given according to assessment resuits of neurodevelopment. Regular parental guidance was given to both of the two groups. Vojta posture reflection, Amil- Tison and Gesell assessment law were used. Results： At the age of 6 months and 12 months, the abnormalities in the intervention group were lower than those in the non-intervention through the examination of Vojta, Amil-Tison （P 〈0. 01 ）. At the age of 6 months, 12 months and lg months, the DQ of every ability in the early intervention group was higher（ P 〈 0. 01 ）. Conclusion： Early individualized coroprehensive intervention can obviously improve the intelligence and physical exercise development of infants with high-risk, and may decrease the occurrence rate of cerebral Pasly. The earlier it is used, the better the effect is.