重度新生儿缺氧缺血性脑病后遗症期前综合性神经康复方法的应用  

Integrating neurological rehabilitation in use of treating severe hypoxic-ischemic encephalopathy new born cases before recovery stage

作　　者：周细中[1] 封志纯[1] 石坚[2] 李宏[1] 刘利辉[2] 钟春霞[1] 

机构地区：[1]第一军医大学附属珠江医院儿科,广州510280 [2]第一军医大学附属珠江医院谊侨康复科

出　　处：《中国康复医学杂志》2003年第6期348-351,共4页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:评价重度新生儿缺氧缺血性脑病(HIE)后遗症期前综合性神经康复方法的效果。方法:分析162例重度HIE患儿住院及随访资料,按接受康复治疗情况分为5组,Ⅰ组患儿接受早期、综合、反复的神经康复治疗;Ⅱ组患儿均于生后6—12个月才开始接受综合的、反复的神经康复治疗;Ⅲ组患儿只在新生儿期接受1个疗程的神经康复药物和高压氧治疗;Ⅳ组患儿仅接受单一的、反复的神经康复药物或高压氧治疗;Ⅴ组患儿未能进行任何康复治疗。精神运动发育状况应用Bayley婴幼儿发育量表随访测试。结果:5组患儿DQ评分结果均数间有着显著差异。其中,Ⅰ组在粗大运动、精细运动、自我照顾和认知社交/语言四部分内容评分均显著高于Ⅱ、Ⅲ、Ⅳ、Ⅴ组(P<0.01);Ⅲ、Ⅳ组粗大运动评分显著高于Ⅱ、Ⅴ组(P<0.01);Ⅱ、Ⅲ、Ⅳ、Ⅴ组间其余部分评分差异无显著性意义(P>0.05)。5组患儿DQ分级比较有显著性差异(P<0.001)。结论:坚持“早期、综合、坚持”的干预原则与措施不失为一种比较理想的可以有效地减少重度HIE所致的神经系统后遗症及发育偏离程度的防治方法。Objective:To assess the effect of integrating neurological rehabilitation in severe hypoxic-ischemic encephalopathy cases before recovery stage.Method:162cases of severe hypoxic-ischemic encephalopathy were collected and they were divided into5groups.Group I were aged below6months and treated with nervous-nutrient drug,hyperbaric oxygenation and functional habilitation for more than7courses.Group II received the same treatments started from6to12months after birth.Group III treated with one course medicine and high baric oxygen during neonate.Group IV were treated with medicine or high baric oxygen.Group V no treatment.Result:To evaluate the patients of5groups with the Bayley Scale,the DQ score were significantly different in the5groups.The scores of gross motor,fine motor,ability of self-care and communication/language.Group I was significantly higher than that of other groups(P<0.01).Groups III and IV were better in gross motor than group II and V(P<0.01).While there was no any other difference of the scores among group II,III,IV and V(P>0.05).The DQ classifications of the5groups were different(P<0.001).Conclusion:Nervous-nutrient drug,hyperbaric oxygenation and functional habilitation for7courses is an effective preventing and treating method in<6months infants.It can reduce nervous system problem after brain injury during perinatal period and facilitate their development.

关 键 词：新生儿 缺氧缺血性脑病 后遗症 综合性神经康复方法 应用 

分 类 号：R49[医药卫生—康复医学]