高危早产儿早期神经发育疗法干预的疗效分析  

Effects of Early Neurodevelopmental Treatment on Motor and Cognitive Development of Critically Ill Premature Infants

作　　者：李娜[1] 康琳敏[1] 王秋[1] 喻韬[1] 马丹[1] 罗蓉[1] 

机构地区：[1]四川大学华西第二医院儿科,成都610041

出　　处：《四川大学学报（医学版）》2013年第2期287-290,共4页Journal of Sichuan University(Medical Sciences)

基　　金：四川省卫生厅科研课题(No.90272);长江学者和创新团队发展计划(No.IRT0935)资助

摘　　要：目的评价神经发育疗法(neurodevelopmental treatment,NDT)早期干预对高危早产儿的运动和认知发育的影响。方法 203例孕周<32周伴极低出生体质量的高危早产儿满足排除和纳入标准,根据家长知情愿意原则分为NDT干预组(n=96)和常规处理对照组(n=107)。NDT干预组在矫正年龄1月至矫正年龄3月每周至医院门诊接受NDT干预1次,矫正年龄3月至12月要求每周至门诊接受NDT训练3～5次,训练方法有主、被动牵拉肢体,促进躯干的对线运动、躯干肢体的负重能力和重心转移能力,引导正常的运动模式、抑制异常的运动模式,刺激肌肉使其主动运动等;NDT干预组和常规处理对照组均辅导教育家属进行常规家庭干预,包括新生儿出院后接受家庭按摩和基于早期教育的简单体操。所有婴儿在矫正年龄3月、6月、9月和12月时接受贝利发育量表(第二版)评分测试。结果 NDT干预对高危早产儿的运动和认知发育有促进作用,NDT干预组测得的精神运动发育指数(PDI)和智力发育指数(MDI)评分(中位数)均高于对照组(P均<0.05)。NDT干预组确诊为脑瘫儿童15例(16.67%),常规处理对照组12例(12.12%),两组脑瘫发生率差异无统计学意义。结论 NDT可以明显改善矫正年龄1岁以内的高危早产儿的运动和认知水平。Objective To study the effects of neurodevelopmental treatment （NDT） on motor and cognitive development of critically ill premature infants. Methods There were 203 infants, who were less than 32 week gestational age （GA）, with very-low birth weight, were included in the study. The infants were assigned to NDT group （n^96） or control group （n=107） according to the parent＇s decision. The infants in NDT group received NDT intervention once per week from corrected age （CA） 1 month to 3 months, and 3 to 5 times per week in the following 9 months. NDT intervention included elongation, establishing alignment, optimizing base of support, facilitation and inhibition, stimulation for activating muscle activity. Both groups received family intervention, such as massage and exercise based on early education. Bayley Scales of Infant Development-II （BSII〉II） score was assessed at 3,6,9,12 months CA for all the infants. Results NDT intervention achieved significant effects on motor and cognitive development. Mental development index （MD1）and psychomotor development index （PDI） of BSID-II were significant higher in NDT group （P〈0.05）. Cerebral palsy was finally diagnosed in 15 children in NDT group （16.67%） and 12 （12.12%） in control group at 12 months CA, there was no significant difference between the two groups （P〉0. 05）. Conclusion NDT intervention can improve motor and cognitive development in critically ill premature infants within 12 months CA.

关 键 词：早产儿 极低出生体质量儿 神经发育疗法 

分 类 号：R722.6[医药卫生—儿科]