Ⅲ度羊水胎粪污染新生儿行为神经测定及其意义

目的探讨对Ⅲ度羊水胎粪污染的新生儿进行新生儿行为神经测定（NBNA）的临床意义。方法对77例Ⅲ度羊水胎粪污染的新生儿及40例足月健康新生儿在出生后7d进行新生儿行为神经测定。77侧Ⅲ度羊水胎粪污染的新生儿分为羊水胎粪污染有活力组38例和羊水胎粪污染无活力组39例。结果Ⅲ度羊水胎粪污染新生儿出生后7d，NBNA评分异常率为23．7％。羊水胎粪污染有活力组NBNA评分异常率高于正常对照组（χ2=9．83，P〈0．01）；羊水胎粪污染无活力组NBNA评分异常率高于正常对照组（χ2=7．01，P〈0．01）；羊水胎粪污染有活力组NBNA评分异常率也高于羊水胎粪污染无活力组，但差异无显著性意义（χ2=0．309，P〉0．05）羊水胎粪污染有活力组、羊水胎粪污染无活力组与正常对照组等3组NBNA的五大项目中比较，羊水胎粪污染有活力组、羊水胎粪污染无活力组两组的行为能力、主动肌张力2项得分均明显低于正常对照组（P〈0．01），而羊水胎粪污染有活力组、羊水胎粪污染无活力组两组的行为能力、主动肌张力2项得分差异无统计学意义（P〉0．05）。结论对Ⅲ度羊水胎粪污染的新生儿，应重视对新生儿神经行为发育的影响，通过NBNA测定，能早期发现轻微脑损伤的婴儿，对优生优育有重要意义。

Neonatal behavioral neurological assessment and significance for newborns with severe meconium stained amniotic fluid

Objective To explore the clinical effects of neonatal behavioral neurological assessment （NBNA） on newborns with severe meconium stained amniotic fluid. Methods NBNA were tested in 77 neo- nates with severe meconium stained amniotic fluid and 40 healthy neonates within 7 days after birth. 77 neonates with severe meconium stained amniotic fluid were divided into vigorous newborns with meconium stained amniot- ic fluid group （n = 38） and non-vigorous newborns with meconium stained anmiotic fluid group （n = 39）. Resuits 23.7% of newborns with severe meconium stained amniotic fluid had total NBNA score ≤35 at 7th day after birth. The abnormal ratio of NBNA score in vigorous newborns with meconium stained amniotic fluid group was higher than those of normal control group（x2 = 9.83 ,P 〈 0. 01 ）. The abnormal ratio of NBNA score in non- vigorous newborns with meconium stained amniotic fluid group was higher than those of normal control group（χ2 = 7.01 ,P 〈 0.01 ）. Both vigorous newborns with meconium stained amniotic fluid group and non-vigorous new- borns with meconium stained amniotic fluid group, the score of behavioral ability and active muscular tonicity was lower than that of normal control group （ P 〈 0.01 ）. Conclusion on We should pay attention to the effects of neurological behavior development on newborns with severe meconium stained amniotic fluid. NBNA could help us find out patients with mild brain injury earlier. This had great significance for bearing and rearing better children.