Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
Department of Neurology, The Six Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
Folia Neuropathol. 2023;61(4):419-425. doi: 10.5114/fn.2023.131551.
The aim of the study was to investigate the effect of ultra-early intervention of nerve and motor development in infants at high risk of cerebral palsy.
One hundred and twenty cases of infants born in The Affiliated Hospital of Harbin Medical University from January 2017 to January 2019 and diagnosed with high risk of cerebral palsy were included in the observation group. In addition, 120 cases of infants at high risk of cerebral palsy (three to five months old) who were admitted to this hospital during the same period were included in the control group, and 120 healthy infants born in the same hospital were included in the healthy group. Intervention was performed on the observation group after diagnosis (within seven days of birth), mainly using neurodevelopmental therapy (NDT). Children in the control group underwent intervention after diagnosis (at three to five months old) using the same measures. The healthy group underwent no intervention. Changes in various indicators were compared among the observation group, healthy group, and control group.
At baseline and at three months, the developmental quotient (DQ) at all functional areas, total DQ, and GESELL development scale (GDS) scores were significantly lower in the observation and control groups than in the healthy group ( p < 0.05). At six months, 12 months, 18 months, and 24 months, the DQ at all functional areas, total DQ, and GDS (adaptability, gross motor, fine motor, language, personal social interaction) scores in the observation and control groups were significantly lower than those in the healthy group ( p < 0.05). However, the observation group scores were significantly higher than the control group scores ( p < 0.05). In the observation group, the normalisation rate was higher than in the control group, and the incidence rate of cerebral palsy and full developmental delay was lower than in the control group ( p < 0.05).
Ultra-early diagnosis and NDT intervention can significantly accelerate the motor development of infants at high risk of cerebral palsy. The earlier, the better. Ultra-early intervention can promote the normalisation of infants at high risk of cerebral palsy and significantly reduce the risk of progression to cerebral palsy.
本研究旨在探讨超早期干预对脑瘫高危儿神经和运动发育的影响。
选取 2017 年 1 月至 2019 年 1 月在哈尔滨医科大学附属第一医院出生并诊断为脑瘫高危儿的 120 例患儿纳入观察组。同期在该院就诊的脑瘫高危儿(35 个月)120 例纳入对照组,同期本院出生的 120 例健康儿纳入健康组。观察组在确诊后(出生后 7 天内)进行干预,主要采用神经发育疗法(NDT)。对照组在确诊后(35 个月)采用相同措施进行干预。健康组不进行干预。比较观察组、健康组和对照组患儿的各项指标变化。
观察组和对照组患儿在基线及 3 个月时的各功能区发育商(DQ)、总 DQ、盖塞尔发育量表(GDS)评分均显著低于健康组(p<0.05);6 个月、12 个月、18 个月和 24 个月时观察组和对照组患儿的各功能区 DQ、总 DQ、GDS(适应性、大运动、精细运动、语言、个人社交互动)评分均显著低于健康组(p<0.05),但观察组评分显著高于对照组(p<0.05)。观察组正常化率高于对照组,脑瘫及全面发育迟缓发生率低于对照组(p<0.05)。
超早期诊断和 NDT 干预可显著促进脑瘫高危儿的运动发育,且越早越好。超早期干预可促进脑瘫高危儿正常化,显著降低向脑瘫进展的风险。