袋鼠式护理干预对缺氧缺血性脑病新生患儿神经行为的影响

Effect of Kangaroo Mother Care Intervention on Neurobehavioral Development in Neonates with Hypoxic Ischemic Encephalopathy

目的观察袋鼠式(kangaroo mother care,KMC)护理干预对缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)新生儿神经行为的影响。方法选择2015年1月—2016年10月于某院就诊的100例缺氧缺血性脑病新生儿患者作为研究对象,随机分为试验组和对照组,每组50例。两组均接受HIE的常规治疗,在此基础上,对照组采取常规护理模式,试验组采取袋鼠式护理模式。评估两组患儿神经发育情况,以及神经系统损害情况。结果与对照组的同时间点相比,试验组患儿行为能力、主动肌张力、被动肌张力、一般反应和原始反射评分均升高,差异均有统计学意义(P均<0.05)。两组患儿行为能力、主动肌张力、被动肌张力、一般反应和原始反射评分均随着时间的延长而逐渐升高;试验组患儿神经系统损害总发生率低于对照组(10.00%<24.00%),差异有统计学意义(P<0.05);试验组患儿肢体功能障碍发生率明显低于对照组(2.00%<10.00%),差异有统计学意义(P<0.05);两组患儿视力障碍、先天性斜颈、口吃、听力障碍和脑瘫发生率无明显差别(P>0.05)。结论 KMC护理能有效改善缺氧缺血性脑病新生儿神经系统,减轻神经系统损害,值得临床推广。

Objective To evaluate the effect of kangaroo mother care（ KMC） intervention on neurobehavioral development in neonates with hypoxic ischemic encephalopathy（ HIE）. Methods 100 cases HIE in our hospital from 2015 January to 2016 October were analyzed,and divided into experimental group（ 50 cases） and control group（ 50 cases）. All neonates with HIE received conventional therapy. Control group received conventional care. Experimental group received KMC. After treatment,neurobehavioral development and nervous system damage were evaluated in two groups. Results Compared with the control group,the test results of general reactions,behavior ability,original reflex,active muscle tension and passive muscle tension in experimental group were significantly higher（ P all 0. 05）. The scores of these neurobehavioral in experimental group were higher when the time was longer. The rate of nervous system damage in experimental group was obviously lower than control group（ 10. 00% 24. 00%）（ P 0. 05）. There were no statistical differences in visual impairment,congenital torticollis,stuttering,hearing impairment,and cerebral palsy between two groups（ P 0. 05）. Conclusion KMC can effectively improve the neurobehavioral development in neonates with HIE,and reduce nervous system damage,which is worthy to be promoted.