新生儿行为神经测定对足月窒息儿预后的评价

目的 探讨新生儿行为神经测定(NBNA)对新生儿重症监护室(Mcu)足月窒息儿预后的预测意义.方法 对NICU住院治疗的326例足月窒息儿分别在12～14d龄、25～28d龄行NBNA测定,并随访至24月龄,行婴幼儿智能发育测定(CDCC)评估.结果 12～14d龄、25～28d龄NBNA评分异常(≤35分)组患儿在24月龄时行CDCC发育评估,智力发育落后智力发育指数(MDI)≤69]发生率分别为61.54%、75.81%;运动发育落后精神运动发育指数(PDI)≤69]发生率分别为65.38%、79.03%,与NBNA评分>35分组相比,差异均有统计学意义(P<0.05).且行为能力中的视听定向项目以及主动肌张力是NBNA的敏感指标.结论 NBNA评分对足月窒息儿的预后有较好的预测意义,对于12～14d龄后NBNA≤35分患儿,特别是视听定向及主动肌张力反应差的患儿需特别注意,要尽早对这些患儿行早期干预治疗.

Value of neonatal behavioral and neurological assessment in prognostic evaluation of full-term neonates with birth asphyxia

Objective To evaluate the prognosis of full-term neonates with birth asphyxia usingneonatal behavioral and neurological assessment (NBNA). Methods A total of 326 full-term neonateswith birth asphyxia were evaluated using NBNA 12-14 days and 25-28 days after birth. The infants werefollowed up till 24 months old and a developmental assessment was made according to the CDCC Scalesof Infant Development. Results The incidence of developmental retardation (with mental developmentindex ≤69 or psychomotor development index ≤69) was significantly higher in the infants with NBNAscores ≤35 than in those with NBNA scores >35. Conclusion The NBNA score provides a valuablereference for prognostic evaluation of the full-term neonates with birth asphyxia, and may serve as asensitive indicator for cerebral lesions.