发育支持护理对极低出生体重儿体质量增长及神经行为发育的影响

The influence of developmentally supportive care on the body weight gain and neurobehavioral development in the very low birth weight infants

目的观察发育支持护理对极低出生体重早产儿体质量及神经行为发育的影响。方法选择2007年6月~2009年3月入住本院NICU的52例极低出生体重儿,采用发育支持护理模式,作为观察组;选择2005年6月~2007年3月在本院NICU住院的48例极低出生体重儿,采用传统护理模式,为对照组。对2组患儿睡眠时间、体质量变化,以及在纠正胎龄40周新生儿神经行为评分（NBNA）,纠正年龄1岁时CDCC评分结果进行比较。结果与传统的护理模式相比,采用发育支持护理模式照顾的早产儿,早产儿的睡眠时间和体质量增加,2组间差异有统计学意义（P〈0.05）,在纠正胎龄40周时,NBNA中行为能力、主动肌张力、被动肌张力、原始反射项目的评分高于对照组（P〈0.05）,在纠正年龄1岁时CDCC评分结果,智能发育（MDI）、运动发育（PDI）方面的评分明显高于对照组（P〈0.05）。结论发育支持护理对极低出生体重儿可促进体质量的增加,促进生长发育,对神经行为的发育有积极的影响。

Objective To observe the influence of developmentally supportive care on the body weight and neurobehavioral development in the very low birth weight infants.Methods The very low birth weight infants admitted to our neonatal intensive care unit from June 2007 to March 2009 were recruited to our observation group,applied a care mode of developmentally supportive care;another group of very low birth weight infants admitted from June 2005 to March 2007 acted as control group,only applied a traditional nursing care.The sleeping hours,body weight gain,neonatal behavioral neurological assessment（NBNA） on its 40th week corrected gestational age,CDCC infant mental development scale on its 1 year old was compared between the two groups.Results The observation group infants statistically slept longer and gained body weight faster than the control group（P0.05）.On its 40th week corrected gestational age,there were significantly more scores in observation group infants than in the control group on the capability,initiative muscular tension,passive muscular tension and primary reflection in the NBNA（P0.05）.Similarly there also were significantly more scores in observation group infants than in the control group on the intellectual development,motor development when they were one year old（P0.05）.Conclusion The developmentally supportive care might benefit the physical growth and neurobehavioral development in the very low birth weight infants.