新生儿行为测定在儿保门诊的应用

陆志宏，马维维

(汉中市中心医院儿童保健中心，陕西 汉中 723000)



新生儿行为测定在儿保门诊的应用

陆志宏，马维维

(汉中市中心医院儿童保健中心，陕西 汉中 723000)

目的探讨新生儿神经行为测定在儿保门诊的应用价值，为早期干预提供临床依据。方法以2013年3月至2015年3月在汉中市中心医院儿童保健中心随诊的389位婴儿为研究对象，有高危因素的200例婴儿为研究组，没有高危因素的189例婴儿为对照组，两组均用统一表格记录出生28日龄时进行新生儿行为神经评定的结果，并进行评分比较。实验组根据评定结果制定康复训练内容，对其父母进行指导训练，保证有效的早期干预；6月龄时对两组婴儿又进行婴幼儿智能发育量表(CDCC)的检查及比较。结果新生儿期28日龄时研究组的行为神经评分低于对照组(χ2=8.685，P<0.05)；但6月龄时两组的发育商相比较没有显著差异(tPDI=0.206，tMDI=0.418，均P>0.05)。结论新生儿行为神经测定是有效、便捷的早期发现脑损伤的方法，应作为儿保门诊早期筛查脑瘫高危儿的常用指标，其对脑损伤早期的干预具有指导性意义。

新生儿行为神经评定；儿保门诊；早期干预；临床依据

[Abstract]Objective To research the application value of neonatal behavioral neurological assessment (NBNA) in child care outpatient service and to provide evidence for early intervention. Methods Totally 389 infants with follow-up in child care outpatient service from March 2013 to March 2015 were selected in study, including 200 infants with high risk factors in research group and the other 189 infants without high risk factors in control group. NBNA was conducted for two groups at 28 days old, and comparison was made. Personalized training was formulated according to evaluation results in the research group, and parents of infants in the research group were guided to ensure effective early intervention. Children’s developmental center of China (CDCC) was applied for two groups to evaluate the score at 6 months old. Results The NBNA scores of the research group were significantly lower than those of the control group at 28 days old (χ2=8.685,P<0.05), but there was no significant difference in CDCC between two groups (tPDI=0.206,tMDI=0.418, bothP>0.05). Conclusion NBNA is an effective and convenient method for indicating cerebral injury at early stage, which should be taken as a conventional index for screening high risk infants with cerebral palsy in child care outpatient service and plays guidance for intervention of cerebral injury at early stage.

[Key words]neonatal behavioral neurological assessment (NBNA); child care outpatient service; early intervention; clinical evidence

新生儿20项行为神经测定(neonatal behaviral neurological assessment, NBNA)是鲍秀兰医生结合Amiel-Tison神经运动测定方法和Breazelton新生儿行为评估评分而创立的行为神经检查方法，通过对新生婴儿各种行为姿势进行科学专业的测定，早期发现脑损伤征象，早期干预，减少脑瘫的发生[1-3]。该方法是一种综合性行为和神经检查法，经济、实用、便捷、无创、可重复，在提示脑损伤方面有一定的价值，本研究通过对在汉中市中心医院儿童保健中心随诊的389位婴儿进行研究分析，旨在分析评价NBNA在儿保门诊进行新生儿期随访时应用的必要性及实用性。……