20项NBNA检查在足月高危儿颅脑损伤筛查及早期干预中的应用价值

Study on the application value of 20 NBNA tests in the screening and early intervention of craniocerebral injury in high-risk term neonates

目的采用20项新生儿行为神经测定(NBNA)检查法筛查足月高危儿颅脑损伤程度,并给予早期干预,评估干预后患儿脑损伤程度及适应能力改善情况。方法选取2017年~2019年间江门中心医院儿保科收治的138例有颅脑损伤高危因素足月患儿为研究对象,通过给予20项NBNA检查筛查脑损伤情况,并根据筛查结果实施针对性的早期干预,评估不同阶段患儿的20项NBNA评分及适应能力评分。结果通过对出生后1、3、4周实施20项NBNA检查,第3周患儿的行为能力评估结果与第1周比较无显著差异(P>0.01),第3周其余指标及第4周的五部分20项指标与第1周相比差异具有统计学意义(P<0.01);第3周20项NBNA检查评分≤35分人数明显少于第1周,第4周20项NBNA检查评分≤35分人数也明显少于第3周;12个月后随访评估高危儿的适应性评分中≤85分者明显少于3个月时≤85分者。结论对于足月有颅脑损伤高危因素患儿实施20项NBNA筛查,有助于早期发现患儿颅脑损伤程度,并给予针对性的早期干预,以此促进患儿脑部神经发育,降低脑损伤程度,提升患儿的适应能力,可20项减少脑损伤对患儿生存质量的影响。

Objective To screen the degree of craniocerebral injury in full-term high-risk newborns by using 20 neonatal behavioral neurological assessment(NBNA)examinations and give early intervention to evaluate the degree of brain injury and the improvement of adaptability of infants after intervention.Methods From 2017 to 2019,138 cases of term neonates with high-risk factors of craniocerebral injury who were admitted to the Department of Pediatrics of Jiangmen Central Hospital were selected as the research subjects.The term neonates with high-risk factors of craniocerebral injury was screened by 20 NBNA examinations,and the targeted results were implemented according to the screening results.Early intervention,20 NBNA scores and adaptability scores of infants at different stages were evaluated.Results By performing 20 NBNA examinations at 1,3,and 4 weeks after birth,there was no significant difference in the performance evaluation of the infants in the third week compared with the first week(P>0.01),the remaining indicators in the third week and the fourth week of the 20 indicators were statistically significant compared with the first week(P<0.01);the number of the infants with 20 NBNA examination scores≤35 in the third week was significantly less than that in the first week,and the number of the infants with the 20 NBNA examination scores≤35 in the fourth week was also significantly less than that in the third week;the number of the infants with assessment of high-risk infants’adaptability score≤85 points after 12 months followed up were significantly less than those after 3 months followed up.Conclusion Implementing 20 NBNA screenings for craniocerebral injury in full-term high-risk infants will help to detect the degree of craniocerebral injury in infants early and give targeted early intervention to promote the development of brain nerves in children and reduce the degree of brain injury in order to improve the adaptability of children,and the impact of brain injury on the quality of life of children can be minimized.