摘要
目的:观察早期抚触干预对缺氧缺血性脑病新生儿康复的影响。方法:将2003-06/2005-06在上饶市人民医院儿科住院的60例中重度缺氧缺血性脑病新生儿随机分为抚触组(30例)和对照组(30例),对照组行常规药物治疗和护理,抚触组在此基础上按正规国际抚触标准由头部、胸部、腹部、四肢、手掌、手指、足底、脚趾、背部的顺序进行全身抚触及(位按摩,2次/d,15min/次,连续2个月。分别于基线(出生当日)、干预后第3,7,14,28和60天对两组新生儿进行神经行为评分,并对两组不同观察时点的行为能力、主动肌张力两个分项目进行评分。统计方法包括独立样本t检验、卡方检验、ANOVA、GLM分析。结果:两组新生儿均完成各项测评,全部进入结果分析。①与基线相比,两组新生儿在治疗第3,7,14,28和60天神经行为评分均明显升高,各时间点评分差异有显著性眼抚触组F(5)=177.46,P<0.001;对照组F(5)=187.90,P<0.001演。进一步不同时点两两比较发现,抚触组治疗第3,7,14和28天神经行为评分均逐渐升高,差异有显著性(P<0.001),第14天与第28天之间、第28天与第60天之间神经行为评分接近,差异无显著性(P>0.05)。对照组第3,7,14,28和60天神经行为评分亦逐渐升高,各时点间差异均有显著性(P<0.05)。GLM分析发现治疗第7,14,28和60天,抚触组神经行为评分均高于对照组,组间差异有显著性。眼F(1)=94.21,P<0.001演。②抚触组第3天行为能力和主动肌张力评分与基线的差异无显著性,而第28天的评分则明显升高,与基线和第3天的差异均有显著性意义(P<0.05)。对照组第3天、第28天的行为能力和主动肌张力评分与基线的差异均有显著性意义(P<0.05)。结论:早期抚触干预在缺氧缺血性脑病治疗中具有一定的辅助作用,能促进缺氧缺血性脑病新生儿神经行为康复。
AIM： To explore the effect of early touch intervention on the neurobehavioral rehabilitation of newboms with hypoxic ischemic encephalopathy （HIE）. METHODS： Sixty newborns with moderate or severe HIE hospitalized in the Department of Pediatrics, Shangrao People＇s Hospital between June 2003 and June 2005 were randomly assigned to touch group （n=30） and control group （n=30）. Both groups received routine phannacotherapy and nursing care, and the touch group received additional whole-body touch and point massage in sequences of head, chest, abdomen, limbs, palm, fingers, sole of foot, toes and back for 15 minutes, twice per day continuously for 2 months. At baseline （the day of birth）, 3, 7, 14,28 and 60 days after intervention, all the subjects were evaluated by neonatal behavioral neurological assessment （NBNA） scale. The behavioral ability and active muscle tension of the 2 groups were also scored at different times. The statistical methods included independent sample t test, chi-squared test, ANOVA and GLM analysis. RESULTS： All the newborns of two groups completed the detections were involved in the result analysis. ①The NBNA scores were significantly higher at 3, 7, 14, 28 and 60 days than those at baseline in both groups, with the significant difference（Touch group：F （5）=177.46, P 〈 0.001;Contrel group： F（5）=187.90,P 〈 0.001）. The pairwise comparison between different times showed the scores of the touch group at 3, 7, 14, and 28 days increased gradually, with the significant difference （P 〈 0.001）. And the NBNA scores were not significantly different between day 14 and day 28, and between day 28 and day 60 in the touch group （P 〉 0.05）. The scores of the control group at 3,7,14,28 and 60 days increased gradually, with the significant difference （P 〈 0.05）. GLM analysis showed the NBNA scores at 7, 14, 28 and 60 days were higher in the touch group than in the control group, with the significant difference （F（1）=94.21, P 〈 0.001）. ②In the touch group, there was no significant difference in the scores of behavioral ability and active muscle tension between day 3 and baseline, while the score of day 28 increased remarkably with the significant difference compared with day 3 and baseline （P 〈 0.05）.As compared with baseline, the scores of behavioral ability and active muscle tension at day 3, day 28 increased in control group, with the significant difference （P 〈 0.05）. CONCLUSION： Early touch intervention has assisted impacts on treating HIE, and improves the neurological and behavioral rehabilitation of newborns with HIE.
出处
《中国临床康复》
CSCD
北大核心
2006年第12期27-29,共3页
Chinese Journal of Clinical Rehabilitation
