Ogi S, Arisawa K, Takahashi T, Akiyama T, Goto Y, Fukuda M, Saito H
Department of Rehabilitation, Nagasaki University Hospital, Nagasaki.
No To Hattatsu. 2001 Jan;33(1):31-6.
We assessed the efficacy of an early intervention program (EIP) designed to promote the neonatal behavioral organization and developmental progress in infants born prematurely. The study subjects consisted of 48 very low birthweight infants (< or = 1,500 gms) who received care in NICU of Nagasaki University Hospital, Nagasaki, Japan. During 1993-1996, the experimental group (n = 30) received the NBAS (Neonatal Behavioral Assessment Scale) based intervention combined with a therapeutic program (EIP), for 44 weeks starting from 38 weeks of postmenstrual age. The control group (historical control, n = 18) received the standard medical-nursing care without EIP during 1990-1992. Developmental outcome was assessed in both groups using the NBAS examination after EIP at 44 weeks of postmenstrual age, and the Bayley Scales at 12 months corrected age. Multivariate analyses were performed to adjust for baseline variables that might be associated with the developmental outcome: sex, appropriate or light for dates infant, birthweight, gestational age, Apgar score at 1 minute, duration of intubation, and NBAS cluster score before EIP. In the NBAS examination after EIP, the experimental group achieved significantly higher scores in orientation, motor performance, state range and state regulation tasks than the control group. Furthermore, the experimental group showed significantly higher Bayley Mental and Psychomotor Developmental Indices compared with the control group. These results suggested that EIP was effective in promoting the neonatal neurobehavioral development of very low birthweight infants.
我们评估了一项早期干预计划（EIP）的效果，该计划旨在促进早产儿的新生儿行为组织和发育进程。研究对象包括48名极低出生体重儿（≤1500克），他们在日本长崎大学医院新生儿重症监护室接受治疗。在1993年至1996年期间，实验组（n = 30）从孕龄38周开始接受基于新生儿行为评估量表（NBAS）的干预，并结合一个治疗计划（EIP），为期44周。对照组（历史对照，n = 18）在1990年至1992年期间接受了无EIP的标准医疗护理。在孕龄44周进行EIP后，使用NBAS检查对两组的发育结果进行评估，并在矫正年龄12个月时使用贝利量表进行评估。进行多变量分析以调整可能与发育结果相关的基线变量：性别、适于胎龄或小于胎龄儿、出生体重、孕龄、1分钟阿氏评分、插管持续时间以及EIP前的NBAS聚类评分。在EIP后的NBAS检查中，实验组在定向、运动表现、状态范围和状态调节任务方面的得分显著高于对照组。此外，与对照组相比，实验组的贝利智力和心理运动发育指数显著更高。这些结果表明，EIP在促进极低出生体重儿的新生儿神经行为发育方面是有效的。
