系统干预管理对脑损伤高危儿神经发育及脑瘫发生率的影响

目的 分析系统干预管理对脑损伤高危儿神经发育及脑瘫发生率的影响。方法 选取本院新生儿重症监护病房收治的足月脑损伤高危儿198例,按家长意愿随机分为干预组103例和对照组95例。两组均给予常规治疗及护理,干预组在此基础上按医院-家庭管理模式给予系统化早期干预管理。比较两组高危儿3、6、12、18月龄时原始反射异常、肌张力异常发生率,以及6、12、18月龄时的发育商及脑瘫发生率。结果 两组高危儿在3月龄时原始反射异常率、肌张力异常率比较差异无统计学意义(P>0.05)。6、12、18月龄时,干预组原始反射异常率(13.59%)、肌张力异常率(5.83%)、脑瘫发生率(0.00%)均明显低于对照组,差异均有统计学意义(P<0.05或<0.01)。6、12、18月龄时干预组智力发育指数(MDI)、运动发育指数(PDI)均明显高于对照组,差异均有统计学意义(P<0.01或<0.001)。结论 系统干预管理有助于促进脑损伤高危儿神经发育、提高智力发育水平,降低脑瘫发生率。

Effect of systematic intervention management on neural development and the incidence of cerebral palsy of high-risk infants with brain damage.

Objective To investigate the influence of the systematic intervention management for neural developmental and the incidence of cerebral palsy of high-risk infants with brain damage. Methods A total of 198 full-term brain injury high-risk infants in the First Affiliated Hospital of Bengbu Medical College neonatal intensive care unit (NICU) were selected and divided into intervention group (n=103) and control group (n=95) according to the parents intend.Two groups were given conventional treatment and care.On this basis,systematic early intervention was given in intervention group according to the hospital-family management mode.Differences of the incidence of abnormal muscle tone and abnormal primitive reflex were compared in two groups of high-risk infants at 3,6,12,18 months.Besides,differences of developmental quotient (DQ) and the incidence of cerebral palsy were compared in two groups of high-risk infants at 6,12,18 months. Results The incidences of abnormal primitive reflex and abnormal muscle tone of 3-months-old infants in two groups had no obvious differences (P>0.05).In terms of 6,12,18-months-old,they were obviously lower in the intervention group than those in the control group.Also,the incidence of cerebral palsy was significantly lower than the control group,difference was statistically significant(P<0.05 or <0.01).In the case of infants at 6,12,18 months,MDI and PDI score in intervention group were obviously higher than those in control group(P<0.01 or <0.001). Conclusion Systematic intervention management helps promote neural development,improve the level of mental development,and reduce the incidence of cerebral palsy of brain injury high-risk infants.