目的 探讨引导式教育(conductive education,CE)早期干预中度新生儿缺氧缺血性脑病(hypoxia ischemia encephalopathy,HIE)的疗效,并比较Peabody运动量表(Peabody Developmental Motor Scales 2,PDMS - 2)和Gesell发育量表对评估疗效结果 的相关性。方法 选取106例确诊为中度HIE的1～3月龄患儿,随机分为观察组和对照组:对照组51例(男28例,女23例),采用常规康复干预措施;观察组55例(男22例,女33例),常规康复基础上加用引导式(conductive education,CE)干预。并进行随访,对两组患儿发育情况均采用PDMS-2和Gesell量表进行评估。并分析两个量表评估结果 的相关性。结果 PDMS-2量表测试结果 , 观察组的正常例数(51/55)显著高于对照组(40/51)(P<0.05);Gesell量表测试结果 ,观察组的正常例数(50/55)显著高于对照组(39/51)(P<0.05)。证明在常规干预基础上家用CE疗效更佳;对两量表评估结果 进行相关性分析发现 ,PDMS-2总运动发育商(TMQ)与Gesell总发育商相近,具有相关性(r=0.925)。其中粗大运动发育商(gross motor quotient,GMQ)与Gesell的粗大运动能区得分之间的相关性更高(r=0.911)。精细运动发育商(fine motor quotient,FMQ)与Gesell量表的精细运动发育能区得分的相关性则相对较低(r=0.790)(P均<0.05)。结论 常规康复干预措施的基础上加用CE疗法早期干预中度HIE患儿比单纯应用常规康复更有效;Gesell量表与PDMS-2量表对HIE的疗效评估具有较好的相关性,以粗大运动的相关性最为密切。

Objective To observe the effect of conductive education(CE) early intervention on infants with moderate hypoxia ischemia encephalopathy (HIE),compare two different Results which evaluated by Peabody Developmental Motor Scales 2 (PPMS-2) and Gesell Scale,and analyze the correlation of them.Methods A total of 106 HIE infants within 1~3 months were divided into two groups.Control group (n=51,28 cases were boys,23 cases were girls) was applied by routine rehabilitation intervene measures.Observation group (n=55,22 cases were boys,33 cases were girls):CE early intervention was added to the base of routine rehabilitation intervention measures.At the age of 11 months,the development state with Gesell scale and PDMS-2 were evaluated. Results The Results of PDMS-2 showed that the number cases of observation group (51/55)was significant higher than that of control group(40/51)(P<0.05).The Results of Gesell scales showed that the normal number of observation group(50/55)was significant higher than that of control group(39/51)(P<0.05).Both Results improved that the effect of routine rehabilitation intervene adding CE intervene was more effective than that of pure routine rehabilitation intervene.And the total quotient /DQ of PDMS-2 and Gesell scales were very closely,which showed high correlation(r=0.925).The correlation coefficient of gross motor quotient was the greatest(r=0.911)while that of fine motor quotient was lower slightly.Conclusion s The routine rehabilitation intervene measures adding CE early intervention is more effective on infants with HIE.There are significant correlations between the PDMS-2 and Gesell Scales,especially in the gross motor.