Pisaturo C, Contegno P, Sodini G
Divisione e Cattedra di Neuropsichiatria Infantile, Università di Genova, Istituto G. Gaslini.
Minerva Pediatr. 1990 Jul-Aug;42(7-8):281-9.
Longterm effects of early rehabilitative treatment are evaluated in 37 premature infants at neurological risk. The late neurological and psychomotor development of this group of children (experimental group) is compared with that of another 35 at risk premature infants (control group), who received only conventional follow-up care. The two groups do not differ in birth-weight, gestational age, sex and neonatal disorders. At 6 years of age the children of the experimental group have a significantly better neurological status and score higher than the control group, on mean mental indices. They also have lower incidence of neurodevelopmental sequelae (learning disabilities and behaviour problems). However children both in the experimental group and the control group have poor visual-motor integration. Similar results are found also in children, who were low-risk premature infants and who have normal intelligence. Our data suggest that a prescribed early rehabilitative treatment for high-risk preterm infants appears enhance the quality of late development. Treated children have the greatest improvement in all measured outcomes at 6 years (included neurological status, motor and overall development), but do not achieve the same level of neurological and behavioral development as full-term control children. One might question whether the latter finding indicate limited efficacy of early treatment or rather the need to consider separate series of norms for the preterm infant in assessing its outcome. This question requires additional follow-up studies.
对37名有神经学风险的早产儿进行早期康复治疗的长期效果评估。将这组儿童(实验组)的后期神经和精神运动发育情况与另外35名有风险的早产儿(对照组)进行比较,后者仅接受常规随访护理。两组在出生体重、胎龄、性别和新生儿疾病方面无差异。在6岁时,实验组儿童的神经状态明显更好,平均智力指数得分高于对照组。他们的神经发育后遗症(学习障碍和行为问题)发生率也较低。然而,实验组和对照组的儿童视觉运动整合能力都较差。在低风险早产儿且智力正常的儿童中也发现了类似结果。我们的数据表明,为高危早产儿规定的早期康复治疗似乎能提高后期发育质量。接受治疗的儿童在6岁时所有测量结果(包括神经状态、运动和整体发育)都有最大改善,但未达到足月对照儿童的神经和行为发育水平。有人可能会质疑后一发现是表明早期治疗效果有限,还是在评估早产儿结局时需要考虑单独的规范系列。这个问题需要进一步的随访研究。