目的 观察NICU病房内早期康复干预对具有高危因素早产儿预后疗效的研究, 为临床治疗提供参考依据。方法 选取2009年1月-2012年7月入住聊城市人民医院NICU病房有高危围生期因素合并有脑损伤的早产儿161例为研究对象, 根据家长的自愿性分为干预组和常规组, 常规组给予一般治疗措施及家庭干预, 干预组在NICU病房即给予早期“康复干预”措施;纠正胎龄40周时行NBNA评分, 纠正年龄3月龄、6月龄时采用Infanib 量表进行早期运动发育评估, 于6、12个月龄时采用CDCC婴幼儿智能发育量表对其进行智力指数测定, 以及后遗症发生率比较。结果 干预组在住院期间各脏器合并症发生率减低, 与常规组比较有统计学意义(P=0.01);两组早产儿在3、6月龄时Infanib评估结果间比较均有统计学意义(P均<0.05);在MDI与PDI方面, 治疗组生后6、12个月时得分均显著高于常规组(P＜0.01);干预组后遗症发生率为11.3%, 明显低于常规组的27.2%(χ²=3.98, P<0.05)。结论 对NICU病房有脑损伤高危早产儿生命体征平稳后行早期康复干预可以明显改善其运动和智能发育, 减少合并症的发生, 缩短住院时间, 值得在基层医院推广和应用。

Objective To evaluate the effect of early rehabilitation intervention on preterm children of high-risk brain injury in NICU, and to provide a reliable basis for clinical application. Methods A total of 161 preterm children were enrolled from January, 2009 to July, 2012, who were divided into two groups based on parents' voluntary, the intervention group(n=86) and the conventional group(n=75).The intervention group received medicine and early rehabilitation.The control group received medicine and family invention.Neonatal Behavioral Neurological Assessment (NBNA) scores were assessed in correct gestational age 40 weeks.Early motor development assessed in 3 and 6 months old.Developmental evaluation were performed in 6 and 12 months old. Results There was lower incidence of complications of multi-organs in invention group (P=0.01).There were significant in Infant Neurological International Battery (Infanib) in 3 and 6 months old (all P<0.05).The developmental quotient (DQ) and mental index(MI) of 6, 12 months old infants in the invention group were higher than those of the control group (P<0.01).The incidence of sequelae was lower in intervention than conventional group (11.3% vs 27.2%)(χ²=3.98, P<0.05). Conclusions Early rehabilitation can promote developement of premature infant with brain damage, reduce the sequelae in NICU and the incidences of complication, shorter the hospital stays.