Objective To investigate effects of early intervention on hypoxic-ischemic encephalopathy (HIE) infants' writhing movements,guide early clinical intervention for HIE infants and improve neuro developmental outcome. Methods 1) The survey was carried among 327 HIE infants during writhing period,following up to well baby clinic,from October 2011 to June 2014.The cases were divided into early intervention group (n=168) and control group (n=159) randomly.Each group was divided into mild HIE group,moderate HIE group,severe HIE group according to damage degree of HIE.2) Early intervention was combined direct intervention and guiding parents for intervention.3)The rate of GMs among each group was compared. Results The number of writhing movement in early intervention group was more than that of the control group (χ2=16.017,P=0.000),while the number of poor repertoire general movements(χ2=10.169,P=0.001) and cramped-sychronised general movements were significantly fewer than those of the control group(χ2=4.246,P=0.039);In mild HIE group and moderate HIE group writhing movements (χ2=10.321,P=0.001;χ2=9.227,P=0.002) and PR (χ2=10.321,P=0.001;χ2=4.490,P=0.034) had significant differences in two groups.In severe HIE group,there were no significant differences in N,PR and CS between the two groups. Conclusion Very early intervention can reduce incidence rate of PR,improve incidence rate of normal writhing movement in mild and moderate HIE group; While there is no effect in severe HIE group.
Key words
early intervention /
hypoxic-ischemic encephalopathy /
writhing movements /
general movements
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 李瑞花,郭光,阙立双,等.脑性瘫痪的危险因素分析[J].实用儿科临床杂志,2009,24(15):1185-1186.
[2] Adde L,Helbostad JL,Jensenius AR,et al.Early prediction of cerebral palsy by computer-based video analysis of general movements:a feasibility study[J].Dev Med Child Neurol,2010,52(8):773-778.
[3] Beccaria E,Martino M,Briatore E,et al.Poor repertoire general movements predict some aspects of development outcome at 2 years in very preterm infants[J].Early Hum Dev,2012,88(6):393-396.
[4] Einspieler C,Marschik PB,Milioti S,et al.Are abnormal fidgety movements an early marker for complex minor neurological dysfunction at puberty?[J].Early Hum Dev,2007,83(8):521-525.
[5] 马良,孟令丹,吕攀攀,等.早期干预对早产儿全身运动质量的影响[J].中国儿童保健杂志,2013,21(2):166-168.
[6] 鲍秀兰,王丹华,孙淑英,等.早期干预降低早产儿脑瘫发生率的研究[J].中国儿童保健杂志,2006,14(1):42-48.
[7] 杨于嘉,姚裕家.新生儿缺氧缺血性脑病诊断标准[J].中华儿科杂志,2005,43(8):584-585.
[8] Einspieler C,Prechtl HFR,Bos AF,et al.Prechtl's method on the qualitative assessment of general movements in preterm,term and young infants (incl.CD-ROM)[M].London:MacKeith Press,distributed by Cambridge University Press,2004.
[9] 黄金华,温晓红,王水云,等.全身运动质量评估和52项神经运动检查对高危儿脑瘫的预测效度对比分析[J].中华物理医学与康复杂志,2011,33(10):755-758.
[10] Dibiasi J,Einspieler C.Can spontaneous movements be modulated by visual and acoustic stimulation in 3-month-old infants?[J].Early Hum Dev,2002,68(1):27-37.
[11] Korzeniewski SJ,Birbecck G,DeLano MC,et al.A systematic review of nruroimaging for cerebral palsy[J].Child Neurol,2008,23(2):216-227.
[12] 林庆.脑性瘫痪[M]//胡亚美,江载芳.诸福棠实用儿科学(下册).7版.北京:人民卫生出版社,2002:1905-1905.
[13] Adde L,Rygg M,Lossius K,et al.General movement assessment:Predicting cerebral palsy in clinical practise[J].Early Hum Dev,2007,83(1):13-18.
PDF(439 KB)
