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目的探讨早期分级、评估及综合干预治疗对0~1岁脑性瘫痪高危儿的影响,为降低当地脑瘫儿的发生率、减轻残疾儿童的功能障碍程度提供科学有效的依据。方法利用全市的脑瘫高危儿转诊系统,对南通市2011年1月1日-12月31日出生的新生儿进行筛查,筛选出的高危儿进行神经系统检查,同时采用PDMS-2量表进行早期分级。其中,神经系统检查异常且总运动商(total motor quotient,TMQ)<80的高危儿,征求家长意愿,分为常规育儿组和早期干预组,分别进行早期教育、综合干预治疗,并于3、6、9、12月龄定期评估。结果本次研究的高危儿最终确诊脑瘫人数为7人,脑瘫的发生率为3.4‰,远低于国内报道的全国脑瘫高危儿脑瘫发病率的7.8‰和南通地区报道的发病率8.1‰,其中,早期干预组脑瘫的发生率明显低于常规育儿组(P<0.05);影响脑瘫高危儿早期综合干预效果的因素很多,以低出生体重和高胆红素血症最为显著(P<0.05)。结论早期分级与综合干预能降低脑瘫高危儿脑瘫的发生率。
Objective To investigate the effect of early grading, assessment and comprehensive intervention on high-risk children with cerebral palsy of 0 ~ 1 year old, and to provide a scientific and effective basis for reducing the incidence of local cerebral palsy children and alleviating the dysfunction of disabled children. Methods The high-risk children with cerebral palsy referral system was used to screen newborns born from January 1 to December 31, 2011 in Nantong City. The high-risk infants were screened for neurological examination and PDMS-2 scale Early grading. Among them, the children with high-risk neurological examination abnormalities and total motor quotient (TMQ) <80 were asked for the wishes of their parents and divided into two groups: conventional nursing group and early intervention group, 6, 9, 12 months of age regularly assessed. Results The number of cerebral palsy diagnosed in this study was 7 and the incidence of cerebral palsy was 3.4 ‰, much lower than the 7.8 ‰ incidence of cerebral palsy in China reported in China and 8.1 ‰ in Nantong (P <0.05). The incidence of cerebral palsy in early intervention group was significantly lower than that in routine parental group (P <0.05). There were many factors influencing early comprehensive intervention in high risk infants with cerebral palsy, with the lowest birth weight and hyperbilirubinemia the most significant (P <0.05) . Conclusion Early grading and comprehensive intervention can reduce the incidence of cerebral palsy in children with cerebral palsy.