不同治疗模式对神经系统发育异常高危儿的疗效观察

Outcomes of different therapies treating high-risk children with abnormal nervous system development

目的对比不同治疗模式治疗神经系统发育异常高危儿的效果。方法选取2015年3月至2016年1月河北省唐山市妇幼保健院300例神经发育异常高危儿,按照随机数字表法分为5组,每组60例。A组予以单纯运动治疗,B组予以运动治疗联合鼠神经生长因子治疗,C组予以运动治疗联合脑循环治疗仪治疗,D组予以运动治疗联合感觉统合训练治疗,E组予以运动治疗联合鼠神经生长因子、脑循环治疗仪、感觉统合训练的综合治疗。治疗9个月后对比5组治疗效果;分别于治疗3、6、9个月后使用0~6岁神经心理学量表测定各治疗组患儿发育商;治疗9个月后采用52项神经系统检查评估患儿神经系统发育情况。结果 E组总有效率高于A、B、C、D组[88. 3%(53/60)比61. 7%(37/60)、70. 0%(42/60)、70. 0%(42/60)、68. 3%(41/60)],差异有统计学意义(χ~2=11. 655,P=0. 020)。5组治疗前发育商差异无统计学意义(P> 0. 05)。治疗后各组发育商均较治疗前上升,差异均有统计学意义(均P <0. 001),且随治疗时间延长患儿发育商呈增长趋势,治疗3、6、9个月后E组高于A、B、C、D组(均P <0. 05)。E组神经系统发育正常率高于A、B、C、D组[75. 0%(45/60)比50. 0%(30/60)、53. 3%(32/60)、53. 3%(32/60)、51. 7%(31/60)],差异有统计学意义(χ~2=10. 453,P=0. 034);5组临界异常率、异常率差异无统计学意义(χ~2=4. 621、5. 222,P=0. 328、0. 265)。结论运动治疗联合鼠神经生长因子、脑循环治疗仪、感觉统合训练的综合疗法能显著促进神经系统发育异常高危儿的神经发育,且治疗时间越长,患儿神经发育越完善。

Objective To analyze the effects of different treatment modes on high-risk children with abnormal nervous system development. Methods From March 2015 to January 2016,300 high-risk children with abnormal nervous system development admitted to Tangshan Maternal and Child Health Care Hospital,Hebei Province were randomly divided into 5 groups,with 60 cases in each group. Group A had simple exercise therapy;group B was treated with mouse nerve growth factor and exercise;group C was treated with cerebrovascular function therapy and exercise;group D was treated with sensory integration training and exercise;group E was treated with mouse nerve growth factor,cerebrovascular function therapy,sensory integration training and exercise.Therapeutic effect was observed after 9 months of treatment. Developmental quotient( DQ) of children was measured by the 0-6 years old neuropsychological scale after 3,6,9 months of treatment. Neurodevelopment was assessed by the 52-item neurological examination after 9 months of treatment. Results Total effective rate in group E was significantly higher than that in group A,B,C,D[88. 3%( 53/60) vs 61. 7%( 37/60),70. 0%( 42/60),70. 0%( 42/60),68. 3%( 41/60) ]( χ~2= 11. 655,P = 0. 020). DQ showed no statistical difference among the 5 groups before treatment( P > 0. 05) and significantly increased after treatment( P < 0. 001);the values of DQ at 3,6,9 months after treatment in group E were significantly higher than those in group A,B,C,D( all P < 0. 05). Normal rate of neurodevelopment in group E was significantly higher than that in group A,B,C,D[75. 0%( 45/60) vs 50. 0%( 30/60),53. 3%( 32/60),53. 3%( 32/60),51. 7%( 31/60) ]( χ~2= 10. 453,P =0. 034). There were no significant differences in critical anomaly rate and abnormal rate of neurodevelopment among the 5 groups( χ~2= 4. 621,5. 222;P = 0. 328,0. 265). Conclusion Exercise therapy combined with mouse nerve growth factor,cerebrovascular function therapy and sensory integration training can effectively promote neurodevelopment in children with abnormal nervous system development,and the therapeutic effect advances along with the duration of treatment.