早期综合干预对早产脑损伤患儿神经发育的影响

Effect of early comprehensive intervention on neurodevelopment in children with premature brain injury

目的评估早期综合干预对患儿神经运动和精神发育的影响。方法选择2018年1~6月在陕西省宝鸡市妇幼保健院小儿神经内科与康复科就诊的早产脑损伤患儿140例,根据单双日法随机分为干预组和对照组,每组70例,对照组进行常规干预,干预组进行早期综合干预。干预6、12个月后,评估两组患儿神经运动发育、智力发展指数(MDI)、精神运动发展指数(PDI)及脑瘫、精神发育迟滞发生率。结果干预组干预6、12个月后患儿神经运动发育异常项目发生率均低于对照组(P> 0.05)。干预12个月后,两组MDI和PDI均高于干预6个月后(P <0.05);干预组患儿脑瘫、精神发育迟滞发生率低于对照组(P <0.05)。结论应用小儿推拿、主动运动治疗、作业治疗等早期综合干预能够显著改善早产脑损伤患儿综合发育商,并可明显降低脑瘫、精神发育迟滞等后遗症的发生率,改善患儿预后。

Objective To evaluate the effects of early integrated intervention on neuromotor and mental development in children. Methods From January to June 2018, 140 cases with brain injury in premature infants who treated in Department of Pediatric Neurology and Rehabilitation, Baoji Women and Children′s Health Care Center of Shaanxi Province were selected. They were randomly divided into intervention group and control group, according to single and double day method, with 70 cases in each group. Control group was given routine intervention, and intervention group was given early comprehensive intervention. After interventions for 6, 12 months, the development of neuromotor development,mental development index(MDI), and psychomotor dewelopment index(PDI), cerebral palsy, and mental retardation were evaluated. Results The incidence of neuromotor dysplasia in intervention group after 6, 12 months intervention was lower than that of control group(P > 0.05). After 12 months of intervention, MDI and PDI scores of two group were higher than those after 6 months of intervention(P < 0.05), and the incidence of cerebral palsy and mental retardation of intervention group was lower than that of control group(P < 0.05). Conclusion Early comprehensive interventions such as pediatric massage, active exercise therapy, and occupational therapy can significantly improve the comprehensive developmental quotient of children with premature brain injury, and can significantly reduce the incidence of sequelae such as cerebral palsy and mental retardation, and improve the prognosis of children.