早期综合康复干预对早产儿脑性瘫痪发生率及智能的影响

Effects of early comprehensive rehabilitation intervention on the incidence of cerebral palsy and intellectual development of premature infants

目的观察早期综合康复干预治疗对降低早产儿脑性瘫痪发生率及智能影响的效果。方法选择2012年6月至2013年12月在彩虹集团公司彩虹医院儿保康复科就诊的158例无合并症的早产儿为研究对象,按照就诊编号和家长自愿的原则,73例早产儿从纠正胎龄40周开始进行早期医疗康复干预结合家庭干预(综合干预组),85例早产儿只行常规的家庭干预(常规干预组),两组患儿均在3、6、9、12个月用发育量表检查发育商,1岁时进行脑瘫诊断和排除诊断。结果从9月龄后,综合干预组儿童各能区得分均高于常规干预组儿童,且综合干预组儿童6月龄时的社交能力(t=2.53,P<0.05);9月龄时的社交能力(t=2.50,P<0.05)和语言能力(t=2.04,P<0.05);12月龄时的大运动(t=4.00,P<0.05)、精细运动(t=2.40,P<0.05)、适应能力(t=2.34,P<0.05)和社会行为(t=2.12,P<0.05)得分都明显高于常规干预组。综合干预组儿童脑性瘫痪的检出率为4.1%(3/73),明显低于常规干预组的12.9%(11/85),x^2=6.10,P<0.05。结论早期综合康复干预对早产儿脑性瘫痪有显著的预防作用,对婴儿期智能发展具有明显的促进作用。

Objective To assess the effects of early comprehensive intervention and rehabilitation therapy on the incidence of cerebral palsy and intellectual development in premature infants .Methods Totally 158 preterm infants without complications were included , who did health care examination in rehabilitation department of Rainbow Hospital of Rainbow Group Company during the period of June 2012 to December 2013.Based on the number and voluntary principle , 73 preterm infants （ intervention group ） received early medical rehabilitation intervention combined with family intervention from 40 weeks of corrected gestational age , and the other 85 preterm infants （control group） received routine family intervention .Developmental scale was used to examine their development at the age of 3, 6, 9, and 12 months, and cerebral palsy diagnosis was done when they were 1-year old.Results The scores of developmental scale of each region were higher in the intervention group than those of the control group from age of 9 months.The score of social skill at age of 6 months （t=2.53,P〈0.05）, social skills （t=2.50, P＆lt;0.05） and language skills （t=2.04,P〈0.05） at age of 9 months, cross motor （t=4.00, P〈0.05）, fine motor （t =2.40,P 〈0.05）, adaptation （t =2.34,P 〈0.05） and social behavior （t =2.12,P 〈0.05） in the intervention group were significantly higher than those of the controls .The detection rate of cerebral palsy in the intervention group was 4.1%（3/73） , which was significantly lower than that of the control group （12.9%, 11/85） （χ2 =6.10, P＆lt;0.05）.Conclusion Early comprehensive rehabilitation intervention has preventive effect on cerebral palsy , and plays an important role in improving the intelligence development of premature infants .