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目的探讨早期干预对降低早产儿脑性瘫痪(简称脑瘫)发生率的作用。方法来自全国各协作单位的1053例早产儿按研究开始前、后的时间和家长意愿分为早期干预组(551例)和常规育儿组(502例)。干预组自早产儿出院开始除接受常规育儿指导外,通过家长对早产儿进行认知、语言、情感和交往能力培养,并重点进行按摩、体操和主动运动训练,出现运动异常者做相应康复训练。常规组只接受与干预组相同的常规育儿指导。结果两组男女比例、孕母并发症、平均胎龄和出生体重、小于胎龄儿的比例、单胎和多胎的比例、胎内窘迫、生后窒息、新生儿缺血缺氧性脑病和颅内出血的发生率、Apgar评分和纠正胎龄40周新生儿行为神经测查评分差异均无统计学意义(P>0.05),说明两组有可比性。1岁时脑瘫发生率干预组为0.91%(5/551),常规组为3.19%(16/502)(P<0.01)。干预组5例脑瘫患儿中3例为轻度,2例为重度;常规组16例中7例为中度,9例为重度。结论早产儿早期干预可降低早产儿脑瘫发生率,此结论有待扩大样本重复验证。
Objective To explore the effect of early intervention on reducing the incidence of cerebral palsy (referred to as cerebral palsy) in preterm infants. Methods 1053 preterm infants from various cooperative units in China were divided into early intervention group (n = 551) and conventional parental care group (n = 502) according to the time before and after the study and their parents’ wishes. In intervention group, from the beginning of discharge, the mothers of the preterm infants were trained in cognitive, language, emotional and communication skills through prenatal guidance except regular instruction of child-rearing, and massage, gymnastics and active exercise were emphasized. . The conventional group only received the same routine parental guidance as the intervention group. Results The proportions of males to females, maternal complications, average gestational age and birth weight, proportion of infants less than gestational age, proportion of single and multiple births, fetal distress, postnatal asphyxia, neonatal hypoxic-ischemic encephalopathy and intracranial hemorrhage The incidence of Apgar score and correction of 40-week gestational age neonatal behavioral neurological assessment score was no significant difference (P> 0.05), indicating that the two groups were comparable. The incidence of cerebral palsy at 1 year old was 0.91% (5/551) in the intervention group and 3.19% (16/502) in the conventional group (P <0.01). Three of the five children with cerebral palsy in the intervention group were mild and two were severe; in the conventional group, seven were moderate and nine were severe. Conclusion Early intervention in preterm infants can reduce the incidence of cerebral palsy in preterm infants. This conclusion needs to be repeated to verify the samples.