高危儿和特异性高危儿早期干预的进展  

Advances of early intervention in high-risk and specific high-risk infants

作　　者：唐久来[1] 方玲玲 杨李[1] 许晓燕[1] 李恩耀[3] Tang Jiulai;Fang Lingling;Yang Li;Xu Xiaoyan;Li Enyao(Pediatric Neurorehabilitation Center,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui Pro-vince,China;Department of Pediatrics,the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,Anhui Province,China;Department of Child Rehabilitation Medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]安徽医科大学第一附属医院小儿神经康复中心,合肥230022 [2]安徽中医药大学第一附属医院儿科,合肥230031 [3]郑州大学第五附属医院儿童康复医学科,450000

出　　处：《中华实用儿科临床杂志》2020年第24期1841-1845,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家科技支撑计划项目 (2014BAL03B00)。

摘　　要：高危儿大多数可以发育为正常儿童,部分可能发展为脑性瘫痪(脑瘫)高危儿和孤独症谱系障碍高危儿等特异性高危儿,以及发育指标延迟和神经发育障碍性疾病。应用贝利婴幼儿发展量表(BSID)、全身运动质量评估(GMA)和Hammersmith婴幼儿神经系统检查(HINE)等神经发育评估量表进行定期随访筛查,早期发现,尽早干预,可大大提高预后。母亲-婴儿事务处理课程、反应性及语前环境教学和家庭为中心的积极应对和照护特殊需要婴儿方案等以家庭为中心的干预模式已成国际共识,即培训家长,让家长掌握新生儿和婴幼儿神经心理发育规律、亲子互动技巧、早期干预方法和婴儿护理等基本技能。医师定期与家长互动可不断提高家长的早期发现和干预能力。目标-强化运动-丰富环境刺激方法对脑瘫高危儿预后效果好,早期强化行为干预和孤独症婴幼儿早期介入丹佛模式对孤独症谱系障碍高危儿预后效果最佳。脐血干细胞移植对28周前极早产儿进行神经保护和神经修复的临床前和临床研究已经开始。Most infants at high risk would develop into normal children,while others may develop specific infants at high risk,such as cerebral palsy,autism spectrum disorder,developmental retardation,and neurodevelopmental disorders.However,early detection and intervention by using Bayley Scales of Infant Development(BSID),general movement assessment(GMA)and the Hammersmith infant neurological examination(HINE)for follow-up screening can greatly improve the prognosis.Family-centered intervention models,including mother-infant transaction program,responsivity and prelinguistic milieu teaching,and talk and care for infants with special needs,namely,a family-centered programme,has become an internationally agreement.Training parents enable the parents of newborns and infants to master basic skills of neuropsychological development,parent-child interaction skills,early intervention methods and baby care.The regularly interaction of physicians and parents could improve parents'early detection and intervention skills.A method of good prognostic effect for infant at high risk of cerebral palsy is goals-activity-motor enrichment programme.Meanwhile,early intensive behavioral intervention and parents-implemented early start Denver model,which has the best effect on infant at high risk of autism spectrum disorder.Most importantly,preclinical and clinical studies on neuroprotection and nerve repair in extremely premature babies 28 weeks ago who obtained initiated through umbilical blood stem cell transplantation have started.

关 键 词：高危儿 脑性瘫痪高危儿 孤独症谱系障碍高危儿 早期干预 脐血干细胞移植 

分 类 号：R720.597[医药卫生—急诊医学]