应用20项新生儿行为神经测定对高危儿早期干预的研究

Research on early intervention to high risk infant by taking 20 items of neonatal behavioral neurological assessment

目的 :了解高危儿神经系统的损伤情况 ,早期干预 ,防止伤残。方法 :设自然分娩的正常足月新生儿 30例 ,轻度窒息儿 30例 ,足月择期剖宫产儿 30例 ,早产儿 2 0例 ,按中国 2 0项新生儿行为神经测定 (NBNA)评分法 ,在生后 4～ 7d、12～ 14d、2 6～ 2 8d进行 3次测定。结果 :轻度窒息儿与正常新生儿比较差异非常显著 (P <0 .0 1) ,轻度窒息组第 3次测定与生后第 1次测定差异也有显著性。早产儿与正常新生儿比较 ,3次测定差异均非常显著 (P <0 .0 1)。剖宫产儿组生后 4～ 7d与正常新生儿比较差异非常显著 (P <0 .0 1) ,但第 2次和第 3次测定与正常新生儿比较无明显差异 (P >0 .0 5 )。结论 :新生儿窒息、早产儿是影响新生儿脑功能、运动能力的一个重要因素 ,早产儿的脑功能和运动能力可随着日龄的增长而逐渐恢复 ,早期干预有利于促进高危儿的脑功能恢复 ,愈早愈好 。

Objective : To find out the damnification in the nerve system of babies in high risk infant, using early intervention treatment to avoid disability. Method:Taking 30 natural-labored healthy mature babies, 30 low grade-asphyxia babies, 30 caesarean mature babies and 20 preterm infants as observation samples. According to the 20 items of Neonatal Behavioral Neurological Assessment, to make 3 testing on the 4th～7th, 12th～14th, 26th～28th day after their birth.Results: There is a notable difference between lowgrade-asphyxia babies and healthy babies (P<0.01); there is also a notable difference between the first testing and the third testing of lowgrade-asphyxia babies; the difference of the three testing results between preterm infants and healthy babies is also notable(P<0.01); the first testing result of caesarean babies has a notable difference compared with healthy babies(P<0.01), but the 2nd and 3rd testing results has no notable difference compared with healthy babies(P>0.05).Conclusion: Asphyxiation & preterm infant are very important factors in influencing the brain function and motor ability of newborn babies. The brain function and motor ability of preterm infants can be gradually restored with the increase of days. Early intervention is beneficial in the restorability of brain function for high risk infant, and earlier treatment is encouraged, and such treatment can also decrease the disability rate.