早期家庭康复对脑瘫高危儿运动和认知发育的疗效观察

目的：研究早期家庭康复对脑瘫高危儿（IHRCP）运动和认知发育的影响。方法：将115例脑瘫高危儿采用单双号随机分为干预组57例和对照组58例。2组均采用脑瘫高危儿早期综合干预6个月，干预组另加用门诊早期家庭康复指导和家庭康复。干预前和干预后3及6个月，采用粗大运动功能测试量表（GMFM）、精细运动功能评定量表（FMFM）及Gesell发育诊断量表（GDDS）进行疗效评估。纠正胎龄后12月龄进行随访，判定诊断为全面性发育迟缓（GDD）、脑性瘫痪（CP）、孤独症谱系障碍/孤独症谱系障碍高危儿（ASD/IHRASD）的人数。结果：干预后3及6个月，2组GMFM评分、FMFM评分、适应性行为评分、语言评分均较治疗前呈逐渐提高趋势（均P＜0.05），且观察组各时间点各项评分均较对照组显著提高（均P＜0.01）。纠正胎龄后12月龄，干预组诊断为GDD、CP、ASD/IHRASD的人数较对照组显著减少（P＜0.05）。结论：早期家庭康复可以提高脑瘫高危儿粗大运动功能、精细运动功能及认知、语言功能，能够改善脑瘫高危儿的不良预后。

Efficacy of early family rehabilitation for motor and cognitive development of infant at high risk of cerebral palsy

Objective: To study the efficacy of early family rehabilitation for motor and cognitive development in infant at high risk of cerebral palsy (IHRCP). Methods: A total of 115 infants at high risk of cerebral palsy were randomly divided into intervention group (n=57) and control group (n=58). Both groups were treated with early comprehensive intervention for 6 months in high-risk infants with cerebral palsy, and the intervention group was additionally given outpatient early family rehabilitation guidance and family rehabilitation. Before and 3 and 6 months after the intervention, the curative effectiveness was evaluated by gross motor function test scale (GMFM), fine motor function assessment scale (FMFM) and Gesell developmental diagnosis scale (GDDS). The infants were followed up at 12th month after correcting the gestational age, and the number of children diagnosed with global developmental delay (GDD), cerebral palsy (CP), autism spectrum disorder (ASD)/infant at high risk of autism spectrum disorder (IHRASD) were determined. Results: At 3rd and 6th month after intervention, the scores of GMFM, FMFM, adaptive behavior and language in the two groups were significantly increased as compared with those before treatment (P<0.05), and those in the intervention group were significantly higher than those in the control group (P<0.01). At 12th month after correcting gestational age, the number of patients diagnosed with GDD, CP, ASD/IHRASD in the intervention group was significantly less than that in the control group (P<0.05). Conclusion: Early family rehabilitation can improve gross motor function, fine motor function, cognitive and language function, and improve the poor prognosis of IHRCP.