Duran Ridvan, Görker Işik, Küçükuğurluoğlu Yasemin, Çiftdemir Nükhet Aladağ, Vatansever Özbek Ulfet, Acunaş Betül
Department of Pediatrics, Trakya University Faculty of Medicine, Edirne, Turkey.
Pediatr Int. 2012 Feb;54(1):56-9. doi: 10.1111/j.1442-200X.2011.03463.x. Epub 2011 Nov 10.
In previous studies, it has been demonstrated that Neonatal Resuscitation Program (NRP) courses improve the early outcomes of infants with perinatal asphyxia, but there has been no evidence to demonstrate the effect of NRP on long-term outcomes of perinatal asphyxia. The goal of the present study was to determine the effect of NRP courses on the long-term neurodevelopmental outcome of perinatal asphyxia.
This prospective study included infants referred to the Neonatal Unit during the years 2003-2005. Those patients who were referred before NRP courses (pretraining period) were designated as group 1, those who were referred after the first NRP course (transition period) as group 2, and those who were referred after the second NRP course (post-training period) as group 3. Neurodevelopmental outcomes were assessed and compared at 4-6 years of age.
The study involved 40 patients: 23 in group 1, nine in group 2 and eight in group 3. The number of patients who had been diagnosed with cerebral palsy was 13 in group 1, two in group 2, and one in group 3, which was a significant decrease. The number of patients with seizures and electroencephalography abnormality was 12 and 14 in group 1, three and two in group 2, and one and one in group 3, respectively, which was also a significant decrease.
NRP courses have positive effects on short-term as well as long-term neurodevelopmental outcomes of infants with perinatal asphyxia. Further studies are required to determine the effects of NRP courses on minor deficits, such as cognitive and behavioral disturbances.
在先前的研究中,已证明新生儿复苏项目(NRP)课程可改善围产期窒息婴儿的早期结局,但尚无证据表明NRP对围产期窒息的长期结局有影响。本研究的目的是确定NRP课程对围产期窒息婴儿长期神经发育结局的影响。
这项前瞻性研究纳入了2003年至2005年期间转诊至新生儿科的婴儿。那些在NRP课程之前转诊的患者(培训前期)被指定为第1组,在第一次NRP课程之后转诊的患者(过渡期)为第2组,在第二次NRP课程之后转诊的患者(培训后期)为第3组。在4至6岁时评估并比较神经发育结局。
该研究涉及40名患者:第1组23名,第2组9名,第3组8名。被诊断患有脑瘫的患者数量在第1组为13名,第2组为2名,第3组为1名,有显著下降。癫痫发作和脑电图异常的患者数量在第1组分别为12名和14名,第2组为3名和2名,第3组为1名和1名,也有显著下降。
NRP课程对围产期窒息婴儿的短期和长期神经发育结局均有积极影响。需要进一步研究以确定NRP课程对轻微缺陷(如认知和行为障碍)的影响。