围产期脑损伤高危儿早期康复治疗的临床观察  

Early intervention for high-risk infants of perinatal cerebral injury

作　　者：黄真[1] 席宇诚[1] 周丛乐[2] 王素环[2] 

机构地区：[1]北京大学第一医院物理医学与康复科,100034 [2]北京大学第一医院儿科新生儿专业组

出　　处：《中国康复医学杂志》2005年第6期426-428,共3页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:通过分析围产期脑损伤高危儿早期康复治疗的方法和效果,探讨降低脑性瘫痪(脑瘫)的发生率和减轻脑瘫的伤残程度的有效途径。方法:对195例平均月龄为(2.50±1.45)个月的高危儿进行早期康复治疗,治疗前或治疗初期明确诊断脑瘫者34例,平均确诊月龄(4.42±2.17)个月。可疑脑瘫161例。康复评定采用Gesell量表、小儿神经系统检查法及脑瘫功能评定等综合方法。结果:在平均月龄(9.65±3.00)个月时治疗结果显示,34例明确诊断脑瘫患儿中,19例(55.9%)正常,12例(35.3%)临界正常,3例(8.8%)异常。可疑脑瘫的161例高危新生儿中,154例(95.7%)正常,7例(4.3%)临界正常,无一例异常。140例颅脑影像学异常者中,120例(85.7%)正常,17例(12.1%)临界正常,3例(2.14%)异常。早产儿、低出生体重儿、窒息儿、缺氧缺血性脑病患儿、高胆红素血症儿等高危新生儿的脑瘫发生率也明显降低。结论:对围产期脑损伤高危儿的早期康复治疗可以降低脑瘫后遗症的发生。脑瘫的早期康复治疗可以达到临床治愈的效果。Objective: To investigate and evaluate the method of early intervention for high-risk infants, in order to reduce the sequelae of perinatal brain damages. Method: One hundred and ninety-five infants(125 boys,70 girls) ranging from 1 day to 6 months(average age: 2.50±1.45months) underwent an early intervention program. One hundred and sixty-one of them were suspected as high-risk infants of cerebral palsy(CP), and the other 34 infants were diagnosed CP when their average age was 4.42±2.17months. The Gesell Scale of Infant Development and neurologic examination were used for evaluation. One hundred and ninety infants(97.4%) were examined with ultrasound, CT or MRI. One hundred and forty of them(73.7%) were found brain damages with different severity,and 50 of them(26.3%) were normal. Result: The results were investigated when the average age of the infants was(9.65±3.00) months. Among 34 infants with CP, 19(55.9%) infants were clinically cured,12(35.3%) were at borderline and only 3(8.8%) remained abnormal. One hundred and fifty-four infants(95.7%) with suspected CP have developed normal, 7(4.3%) were at borderline and none of them were abnormal. Among 140 infants with brain damages,120(85.7%) infants were clinically normal, 17(12.1%) were at borderline and 3(2.14%) remained abnormal. The prevalence of CP among the infants with premature, low birth-weight, apnea, hypoxic ischemic encephalopathies and neonatal hyperbilirubinemia were reduced significantly. Conclusion: The sequelae of perinatal brain damages could be reduced by early intervention of high-risk infants of CP, and the clinical cure effect could be achieved by early rehabilitation of infants with CP.

关 键 词：围产期 高危儿 脑性瘫痪 早期康复 

分 类 号：R714.7[医药卫生—妇产科学]