早期丰富环境家庭康复对0~6个月脑瘫高危儿的临床疗效观察

Clinical observation of family-based early environmental enrichment rehabilitation for 0- to 6-month-old infants at a higher risk for cerebral palsy

目的分析早期丰富环境家庭康复对0~6月龄脑瘫高危儿粗大运动功能(GMFM)和日常活动能力(ADL)的影响,为临床应用提供科学理论依据。方法选取2015年8月-2018年8月在台州市妇女儿童医院儿保科门诊随访的脑瘫高危儿124例,随机分为对照组和治疗组。对照组采取常规康复训练,治疗组在对照组的基础上,根据初诊时评估的情况进行视觉、听觉、触觉干预以及家庭姿势管理等丰富环境家庭康复指导。在初诊、干预3个月、干预6个月分别对两组患者的GMFM评分和ADL评分进行评定。结果两组研究对象在初诊时年龄、性别、GMFM评分和ADL评分上差异无统计学意义(P>0.05)。在干预3个月后,干预组的CMFM评分(t=5.594,P<0.001)和ADL评分(t=9.793,P<0.001)均较对照组高;在干预6个月后干预组的GMFM评分(t=8.829,P<0.001)和ADL评分(t=11.469,P<0.001)均较对照组高。两组患者在干预3个月后有效率差异无统计学意义(P>0.05),在干预6个月后干预组有效率高于对照组(98.4%vs.80.6%,P<0.05)。结论早期丰富环境家庭康复有利于促进脑瘫高危儿粗大运动功能和日常生活能力的提高。

Objective To analyze the effects of family-based early environmental enrichment rehabilitation on Gross Motor Function Measure Scale(GMFM) and daily activity(ADL) for 0-to 6-month-old infants at high risk of cerebral palsy. Methods A total of 124 infants at higher risk for cerebral palsy who were followed up in Taizhou Women and Children′s Hospital from August 2015 to August 2018 were enrolled in this study, and were randomly divided into the control group and treatment group.The control group was given routine rehabilitation training, while the treatment group was given family-based early environmental enrichment rehabilitation guidance additionally, such as visual, auditory, tactile intervention and family posture management.GMFM and ADL scores of the two groups were evaluated in the first visit, 3 months and 6 months of intervention, respectively. Results There were no significant differences in age, gender, GMFM score and ADL score between the two groups at the time of initial diagnosis(P>0.05).After 3 months of intervention, the GMFM score(t=5.594, P<0.001) and ADL score(t=9.793, P<0.001) of the treatment group were higher than those of the control group.After 6 months of intervention, GMFM score(t=8.829, P<0.001) and ADL score(t=11.469, P<0.001) in the treatment group were higher than those in the control group.After 3 months of intervention, there was no significant difference in the total effective rate between the two groups(P>0.05).But the total effective rate of intervention group was significantly higher than that of control group after 6-month intervention(98.4% vs.80.6%, P<0.05). Conclusion Family-based early environmental enrichment rehabilitation is conducive to improving gross motor function and daily living ability of infants at high risk of cerebral palsy, and significantly improving the prognosis of high-risk infants with cerebral palsy.