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对大量极早产儿进行个体化发育护理:健康、神经行为和神经生理学。

Individualized developmental care for a large sample of very preterm infants: health, neurobehaviour and neurophysiology.

机构信息

Department of Psychiatry (Psychology), Children's Hospital Boston and Harvard Medical School, Boston, MA, USA.

出版信息

Acta Paediatr. 2009 Dec;98(12):1920-6. doi: 10.1111/j.1651-2227.2009.01492.x. Epub 2009 Sep 7.

Abstract

AIM

To assess medical and neurodevelopmental effects of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) for a large sample of very early-born infants.

METHODS

One hundred and seven singleton inborn preterm infants, <29 weeks gestational age (GA), <1250 g birth weight, enrolled in three consecutive phases, were randomized within phase to NIDCAP (treatment, E) or standard care (C). Treatment extended from admission to the Newborn Intensive Care Unit to 2 weeks corrected age (wCA). Outcome included medical, neurobehavioural and neurophysiological status at 2 wCA, and growth and neurobehavioural status at 9 months (m) CA.

RESULTS

The C- and E-group within each of the three consecutive phases and across the three phases were comparable in terms of all background measures; they therefore were treated as one sample. The results indicated for the E-group significant reduction in major medical morbidities of prematurity as well as significantly improved neurodevelopmental (behaviour and electrophysiology) functioning at 2 wCA; significantly better neurobehavioural functioning was also found at 9 mCA.

CONCLUSION

The NIDCAP is an effective treatment for very early-born infants. It reduces health morbidities and enhances neurodevelopment, functional competence and life quality for preterm infants at 2 w and 9 mCA.

摘要

目的

评估新生儿个体化发育护理和评估方案(NIDCAP)对大量极早早产儿的医学和神经发育影响。

方法

在三个连续阶段中,对 107 例单胎宫内早产婴儿(<29 周胎龄(GA),<1250g 出生体重)进行随机分组,分为 NIDCAP(治疗,E 组)或标准护理(C 组)。治疗从新生儿重症监护病房入院延伸至纠正胎龄 2 周(wCA)。结果包括 2wCA 时的医学、神经行为和神经生理学状态,以及 9 个月(mCA)时的生长和神经行为状态。

结果

在每个连续的三个阶段内,E 组和 C 组之间在所有背景测量方面都具有可比性;因此,将它们视为一个样本。结果表明,E 组在早产儿的主要医学并发症方面显著减少,在 2wCA 时神经发育(行为和电生理学)功能显著改善;在 9mCA 时也发现了更好的神经行为功能。

结论

NIDCAP 是极早早产儿的有效治疗方法。它可以降低健康并发症,并增强早产儿在 2w 和 9mCA 时的神经发育、功能能力和生活质量。

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