目的探讨引导式教育(conductive education,CE)早期干预中度新生儿缺氧缺血性脑病(hypoxia ischemia encephalopathy,HIE)的疗效,并比较Peabody运动量表(Peabody Developmental Motor Scales 2,PDMS-2)和Gesell发育量表对评估疗效结果的相关性。方法选取106例确诊为中度HIE的1~3月龄患儿,随机分为观察组和对照组:对照组51例(男28例,女23例),采用常规康复干预措施;观察组55例(男22例,女33例),常规康复基础上加用引导式(conductive education,CE)干预。并进行随访,对两组患儿发育情况均采用PDMS-2和Gesell量表进行评估。并分析两个量表评估结果的相关性。结果 PDMS-2量表测试结果,观察组的正常例数(51/55)显著高于对照组(40/51)(P〈0.05);Gesell量表测试结果,观察组的正常例数(50/55)显著高于对照组(39/51)(P〈0.05)。证明在常规干预基础上家用CE疗效更佳;对两量表评估结果进行相关性分析发现,PDMS-2总运动发育商(TMQ)与Gesell总发育商相近,具有相关性(r=0.925)。其中粗大运动发育商(gross motor quotient,GMQ)与Gesell的粗大运动能区得分之间的相关性更高(r=0.911)。精细运动发育商(fine motor quotient,FMQ)与Gesell量表的精细运动发育能区得分的相关性则相对较低(r=0.790)(P均〈0.05)。结论常规康复干预措施的基础上加用CE疗法早期干预中度HIE患儿比单纯应用常规康复更有效;Gesell量表与PDMS-2量表对HIE的疗效评估具有较好的相关性,以粗大运动的相关性最为密切。
Objective To observe the effect of conductive education(CE)early intervention on infants with moderate hypoxia ischemia encephalopathy(HIE),compare two different results which evaluated by Peabody Developmental Motor Scales 2(PPMS-2)and Gesell Scale,and analyze the correlation of them. Methods A total of 106 HIE infants within 1-3months were divided into two groups.Control group(n=51,28 cases were boys,23 cases were girls)was applied by routine rehabilitation intervene measures.Observation group(n=55,22 cases were boys,33 cases were girls):CE early intervention was added to the base of routine rehabilitation intervention measures.At the age of 11 months,the development state with Gesell scale and PDMS-2were evaluated. Results The results of PDMS-2showed that the number cases of observation group(51/55)was significant higher than that of control group(40/51)(P〈0.05).The results of Gesell scales showed that the normal number of observation group(50/55)was significant higher than that of control group(39/51)(P〈0.05).Both results improved that the effect of routine rehabilitation intervene adding CE intervene was more effective than that of pure routine rehabilitation intervene.And the total quotient/DQ of PDMS-2and Gesell scales were very closely,which showed high correlation(r=0.925).The correlation coefficient of gross motor quotient was the greatest(r=0.911)while that of fine motor quotient was lower slightly. Conclusions The routine rehabilitation intervene measures adding CE early intervention is more effective on infants with HIE.There are significant correlations between the PDMS-2and Gesell Scales,especially in the gross motor.