摘要
目的探讨早期认知训练联合重复经颅磁刺激在新生儿胆红素脑病康复中的应用效果。方法2016年9月至2019年9月,在深圳市龙华区人民医院高危儿门诊随访的88例新生儿胆红素脑病患儿,在病情稳定出院3 d内即由高危儿门诊联合康复科将患儿纳入系统高危随访管理并干预,依从家长意愿将入选病例分为两组,分别为对照组(50例,接受早期认知训练)和观察组(38例,给予早期认知训练同时结合重复经颅磁刺激治疗),对比两组患儿不同月龄新生儿神经行为评分(neonatal behavioral neurological assessment,NBNA)、婴幼儿智力发育检查量表(children's developmental center of China,CDCC)、0~6岁小儿神经心理发育检查表(儿-心量表)评估情况。统计学方法采用独立样本t检验、χ^(2)检验。结果1月龄,观察组患儿的NBNA评分高于对照组[(35.7±4.4)与(31.8±2.9)分],差异有统计学意义(t=10.108,P<0.05);干预6、9、12个月后,两组患儿的智能发育(mental development index,MDI)和运动发育(psychomotive development index,PDI)均高于3个月时,且观察组高于同期的对照组,差异有统计学意义(P<0.05)。患儿12个月时进行儿-心量表评估,结果显示,观察组患儿在精细运动、大运动、语言、适应性、社会交往、发育商等指标方面均明显提高,优于对照组,差异均有统计学意义(P<0.05)。结论在新生儿胆红素脑病康复中开展早期认知训练联合重复经颅磁刺激,临床康复效果显著,值得推广。
Objective To explore the effect of early cognitive training combined with repetitive transcranial magnetic stimulation in the rehabilitation of neonatal bilirubin encephalopathy.Method From September 2016 to September 2019,88 cases of neonates with bilirubin encephalopathy were followed up in the High-Risk Children's Clinic of Longhua District People's Hospital in Shenzhen.The cases were included Systematic high-risk follow-up management and intervention from the High-Risk Children's Clinic and Rehabilitation Department within 3 days of being discharged from the hospital.According to the parents'wishes,the cases were divided into the control group(n=50,received early cognitive training)and the observation group(n=38,given early cognitive training combined with it repeat transcranial magnetic stimulation treatment),the cases with different month-old neonatal behavioral neurological assessment(NBNA),children's developmental center of China(CDCC),0-6 evaluation of the neuropsychological development checklist(child-cardiac scale)for children at age were compared between the two groups.Statistical methods were performed by t-testχ^(2) test.Result At the age of 1 month,the NBNA score in the observation group was higher than that in the control group[(35.7±4.4)vs(31.8±2.9)points],which was statistical significance(t=10.108,P<0.05).Mental development index(MDI)and psychomotive development index(PDI)values of the two groups were higher than that of the three months,and the observation group was higher than that in the control group at 6,9 and 12 months after intervention,which was statistical significance(P<0.05).The cases was evaluated with the child-heart scale at 12 months,the observation group was better than the control group in the fine motor,big movement,language,flexibility,social communication and development business indicators were significantly improved,the difference was statistically significant(P<0.05).Conclusion Early cognitive training combined with repetitive transcranial magnetic stimulation in the rehabilitation of neonatal bilirubin encephalopathy has remarkable clinical rehabilitation effect and is worthy of promotion.
作者
杨晓茜
吴湘兰
Yang Xiaoxi;Wu Xianglan(Department of Rehabilitation,Longhua People's Hospital of Shenzhen,Guangdong,Shenzhen 518109,China;Department of Neonatology,Longhua People's Hospital of Shenzhen,Guangdong,Shenzhen 518109,China)
出处
《发育医学电子杂志》
2022年第2期101-106,共6页
Journal of Developmental Medicine (Electronic Version)
基金
科技创新资金项目(2017118)。
关键词
新生儿胆红素脑病
早期认知训练
重复经颅磁刺激
康复效果
Neonatal bilirubin encephalopathy
Early cognitive training
Repetitive transcranial magnetic stimulation
Effect of rehabilitation
