神经行为测定在发生胎儿窘迫的新生儿中的作用

The Effects of Fetal Distress on the Development of Nervous System in Neonates

目的:评价神经行为的测定在发生胎儿窘迫新生儿中的作用。方法:搜集我院2009年1月至2010年的有胎儿窘迫的指征的新生儿50例,并且随机选取同时期正常生产的新生儿作为对照组。新生儿期患儿在生后1周、3周、4周各检查评估1次(采用20项神经行为测定法NBNA法)。结果:胎儿窘迫组新生儿组出生后3周和4周的新生儿20项行为神经测定法评分明短高于生后1周(P<0.05);足月儿组3周和4周时新生儿20项行为神经测定法评分虽较1周时有所进步,但无明显差异(P>0.05);胎儿窘迫组新生儿组出生后第1周、第3周和第4周与足月正常生产组新生儿在相同时期的20项行为神经测定法各项评分有明显差异(P<0.05)。结论:神经行为的测定可检测到新生儿因胎儿窘迫而引起的脑损伤,因此积极采取措施提高对胎儿窘迫的临床处置,及时进行新生儿神经发育监控,降低因为胎儿窘迫对新生儿神经系统的损伤。

Objective：To evaluate the effects of NBNA on neonatal nervous system development which caused by fetal distress, Methods;Fifty fetal distress newborns were collected from January 2009 to January 2010 in our hospital, at the same time, other fifty normal neonates were randomly selected in the same period as control. Assessments were done after birth 1 week, 3 weeks and 4 weeks between the two groups （using the 20 neurobehavioral assay NBNA method）. Results：The NBNA score in fetal distress group of neonates after birth 3 weeks and 4 weeks were significantly higher than that in 1 week after birth period （P 〈0.05）. Comparing to 1 week after birth, the NBNA score in fetal distress group of neonates after birth 3 weeks and 4 weeks has some progress, but no significant difference （P〉 0.05）; Considering the same period of the two groups significant differences have been found between the NBNA scores（P 〈0.05）. Conclnsion：NBNA score can be applied to early diagnosis of brain damage caused by hyperbilirubinemia. So it is necessary to take active measures to improve the clinical disposition of fetal distress, similar important, to monitor neonatal neurological development and reduce the damage on neonatal nervous system which caused by fetal distress.