袋鼠式护理改善缺氧缺血性脑病新生儿神经系统损害及体格发育的效果评价

Kangaroo care improves the neurological damage and physical development of neonates with hypoxic ischemic encephalopathy

目的:探讨袋鼠式护理(Kangaroo mother care,KMC)改善缺氧缺血性脑病(Hypoxic-ischmic encephalopathy,HIE)新生儿神经系统损害及体格发育的临床价值。方法:选取2016年1月至2018年1月我院收治的缺血缺氧性脑病新生儿80例,采用随机数字方法分为对照组(常规护理,40例)与观察组(袋鼠式护理,40例)。随访40天,比较两组新生儿神经行为、神经系统损害、营养性疾病、体格发育情况。结果:与对照组比较,观察组新生儿出生后7 d、14 d、28 d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明显升高(P<0.05);观察组新生儿神经系统损害总发生率、听力障碍、肢体功能障碍发生率明显低于对照组(P<0.05);观察组新生儿营养性疾病发生率明显低于对照组(P<0.05);观察组新生儿头围、身高、体重的增长均明显优于对照组( P<0.05 )。结论:KMC能促进缺氧缺血性脑病新生儿神经系统及体格的发育,减轻神经系统损害,降低营养不良性疾病的发生。

Objective:To investigate the effects of kangaroo mother care (KMC) in improving neurological damage and physical development in neonates with hypoxic-ischmic encephalopathy (HIE).Methods: Eighty infants with hypoxic-ischemic encephalopathy admitted to our hospital from January2016 to January2018 were enrolled.The patients were randomly divided into the control group (conventional care,40 cases) and the observation group (kangaroo care,40 cases).After 40 days of follow-up,the neurological behavior,nervous system damage,nutritional diseases and physical development of the subjects were compared.Results: Compared with the control group,the behavioral ability,active muscle tone,passive muscle tone,general response and primary reflex score of the observation group were significantly increased at 7 d,14 d,and28 d after birth (P<0.05).The incidence of total neurological damage,hearing impairment,and limb dysfunction was significantly lower than that of the control group (P<0.05).The incidence of neonatal nutritional disease in the observation group was significantly lower than that of the control group (P<0.05).The growth of the head circumference,height and weight was significantly better than the control group (P<0.05).Conclusion: KMC can promote the development of nervous system and physiology of neonates with hypoxic ischemic encephalopathy,reduce nervous system damage and the incidence of dystrophic diseases.