早期康复训练对早产儿脑损伤综合征患者生长发育及神经系统后遗症的影响
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摘要
目的探讨早期康复训练对早产儿脑损伤综合征患者生长发育及神经系统后遗症的影响。方法选取2013年1月～2016年7月脑损伤综合征早产儿180例,根据早产儿家长是否积极参与干预分为干预组134例与对照组46例。对照组早产儿予以常规干预,干预组早产儿在此基础上予以早期康复训练,两组早产儿均干预24个月。观察两组早产儿干预前后生长发育指标的变化,并比较神经系统后遗症情况。结果干预12个月和24个月后,干预组早产儿身高、体质量和智力发育商水平均明显高于对照组(P<0.05);干预24个月,干预组残留的早产儿神经系统后遗症的发生率(7.46%)明显低于对照组(19.57%)(χ~2=4.11,P<0.05)。结论早产儿脑损伤综合征患者予以早期康复训练可修复受损的神经细胞,促进其生长发育,降低残留的神经系统后遗症的发病率,有利于改善患儿的预后。
Objective To investigate the effect of early rehabilitation training on growth and development and neurological sequelae in patients with premature infants with brain injury syndrome. Methods A total of 180 preterm infants with brain injury syndrome from January 2013 to July 2016 were enrolled. According to whether the parents of premature infants actively participated in the intervention,the patients were divided into the intervention group(n=134) and the control group(n=46). The premature infants in the control group were routinely intervened,and the preterm infants in the intervention group were given early rehabilitation training on the above basis. Both groups of premature infants were intervened for 24 months. The changes of growth and development indicators before and after intervention of the two groups were observed,and the sequelae of the nervous system between two groups were compared. Results After12 months and 24 months of intervention, the height, body weight and mental development of the preterm infants in the intervention group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05). After 24 months of intervention,the incidence of neurological sequelae in preterm infants(7.46%) was lower than that in the control group(19.57%),and the difference was statistically significant(χ~2=4.11,P<0.05). Conclusion Early rehabilitation training for patients with brain injury syndrome in premature infants can repair nerve cell damage, promote the growth and development of premature infants, reduce the incidence of neurological sequelae, and improve the prognosis of children.
Objective To investigate the effect of early rehabilitation training on growth and development and neurological sequelae in patients with premature infants with brain injury syndrome. Methods A total of 180 preterm infants with brain injury syndrome from January 2013 to July 2016 were enrolled. According to whether the parents of premature infants actively participated in the intervention,the patients were divided into the intervention group(n=134) and the control group(n=46). The premature infants in the control group were routinely intervened,and the preterm infants in the intervention group were given early rehabilitation training on the above basis. Both groups of premature infants were intervened for 24 months. The changes of growth and development indicators before and after intervention of the two groups were observed,and the sequelae of the nervous system between two groups were compared. Results After12 months and 24 months of intervention, the height, body weight and mental development of the preterm infants in the intervention group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05). After 24 months of intervention,the incidence of neurological sequelae in preterm infants(7.46%) was lower than that in the control group(19.57%),and the difference was statistically significant(χ~2=4.11,P<0.05). Conclusion Early rehabilitation training for patients with brain injury syndrome in premature infants can repair nerve cell damage, promote the growth and development of premature infants, reduce the incidence of neurological sequelae, and improve the prognosis of children.
引文
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[16]李延辉,王风云,杨霞峰,等.早期康复干预对新生儿重症监护病房高危早产儿脑损伤的疗效[J].中国康复医学杂志,2014,29(10):970-972.
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[19]Kidokoro H,Anderson PJ,Doyle LW,et al.Brain injury and altered brain growth in preterm infants:Predictors and prognosis[J].Pediatrics,2014,134(2):e444-453.
[20]詹英杰,陶容妹,陈进勉,等.综合康复干预模式对早产儿脑损伤患儿认知运动发育的影响[J].广东医科大学学报,2018,36(3):317-319.
[21]Baroncelli L,Braschi C,Maffei L.Visual depth perception in normal and deprived rats:Effects of environmental enrichment[J].Neuroscience,2013,236(3):313-319.
[22]De Kieviet JF,Piek JP,Aarnoudse-Moens CS,et al.Motor development in very preterm and very low-birthweight children from birth to adolescence.A meta-analysis[J].JAMA,2009,302(12):2235-2242.
[23]Gulczynska E,Kesiak M,Kryszczynska J,et al.The first application of therapeutic hypothermia in Poland-selective head cooling(Cool-Cap)with whole-body moderate hypothermia in a newborn with features of hypoxic ischemic encephalopathy[J].Ginekol Pol,2012,83(5):384-387.
[24]Holt RL,Mikati MA.Care for child development:Basic science rationale and effects of interventions[J].Pediatr Neurol,2011,44(4):239-253.
[2]Olivieri I,Bova SM,Urgesi C,et al.Outcome of extremely low birth weight infants:What’s new in the third millennium?Neuropsychological profiles at four years[J].Early Hum Dev,2012,88(4):241-250.
[3]马力,温晓红,杨海波,等.影响早产儿脑损伤的相关因素分析[J].中国当代儿科杂志,2016,18(6):471-475.
[4]Baroncelli L,Braschi C,Maffei L.Visual depth perception in normal and deprived rats:Effects of environmental enrichment[J].Neuroscience,2013,236(10):313-319.
[5]陈光福,张蕴芳,陈美清.早产儿脑损伤早期干预模式与临床路径研究[J].中国当代儿科杂志,2014,16(1):35-39.
[6]罗芳,陈正,马晓路,等.Infanib对新生儿重症监护病房出院早产儿早期运动发育及预后评估[J].中国当代儿科杂志,2013,15(1):5-8.
[7]刘敬,杨于嘉,封志纯.“早产儿脑损伤诊断与防治专家共识”解读[J].中国当代儿科杂志,2012,14(7):885-887.
[8]邓松清,付俊鲜,康琳敏,等.振幅整合脑电图在早产儿脑损伤早期诊断的研究[J].四川大学学报(医学版),2013,44(2):280-283.
[9]De Bruine FT,van den Berg-Huysmans AA,Leijser LM,et al.Clinical implications of MR imaging findings in the white matter in very preterm infants:A 2-year follow-up study[J].Radiology,2011,261(3):899-906.
[10]唐娟,陈珊,周伟.早产儿脑损伤的相关生物学标志物[J].国际儿科学杂志,2016,43(3):234-238.
[11]O'Callaghan ME,MacLennan AH,Gibson CS,et al.Epidemiologic associations with cerebral palsy[J].Obstet Gynecol,2011,118(3):576-582.
[12]Hassanein SM,El-Farrash RA,Hafez HM,et al.Cord blood interleukin-6 and neonatal morbidities among preterm infants with PCR-positive ureaplasma urealyticum[J].J Matern Fetal Neonatal Med,2012,25(10):2106-2110.
[13]Back SA,Riddle A,McClure MM.Maturation-dependent vulnerability of perinatal-white matter in premature birth[J].Stroke,2007,38(2):724-730.
[14]Titomanlio L,Kavelaars A,Dalous J,et al.Stem cell therapy for neonatal brain injury:Perspectives and challenges[J].Ann Neurol,2011,70(5):698-712.
[15]McManus BM,Carle AC,Poehlman n J.Effectiveness of Part C early intervention physical,occupational,and speech therapy services for preterm or low birth weight infants in Wisconsin,United States[J].Acad Pediatr,2012,12(2):96-103.
[16]李延辉,王风云,杨霞峰,等.早期康复干预对新生儿重症监护病房高危早产儿脑损伤的疗效[J].中国康复医学杂志,2014,29(10):970-972.
[17]刘俐.早产儿脑损伤及脑发育评估[J].中国实用儿科杂志,2017,32(11):833-837.
[18]Cioni G,D'Acunto G,Guzzetta A.Perinatal brain damage in children:Neuroplasticity,early intervention,and molecular mechanisms of recovery[J].Prong Brain Res,2011,189(2):139-154.
[19]Kidokoro H,Anderson PJ,Doyle LW,et al.Brain injury and altered brain growth in preterm infants:Predictors and prognosis[J].Pediatrics,2014,134(2):e444-453.
[20]詹英杰,陶容妹,陈进勉,等.综合康复干预模式对早产儿脑损伤患儿认知运动发育的影响[J].广东医科大学学报,2018,36(3):317-319.
[21]Baroncelli L,Braschi C,Maffei L.Visual depth perception in normal and deprived rats:Effects of environmental enrichment[J].Neuroscience,2013,236(3):313-319.
[22]De Kieviet JF,Piek JP,Aarnoudse-Moens CS,et al.Motor development in very preterm and very low-birthweight children from birth to adolescence.A meta-analysis[J].JAMA,2009,302(12):2235-2242.
[23]Gulczynska E,Kesiak M,Kryszczynska J,et al.The first application of therapeutic hypothermia in Poland-selective head cooling(Cool-Cap)with whole-body moderate hypothermia in a newborn with features of hypoxic ischemic encephalopathy[J].Ginekol Pol,2012,83(5):384-387.
[24]Holt RL,Mikati MA.Care for child development:Basic science rationale and effects of interventions[J].Pediatr Neurol,2011,44(4):239-253.