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目的探讨对Ⅲ度羊水胎粪污染的新生儿进行新生儿行为神经测定(NBNA)的临床意义。方法对77例Ⅲ度羊水胎粪污染的新生儿及40例足月健康新生儿在出生后7d进行新生儿行为神经测定。77侧Ⅲ度羊水胎粪污染的新生儿分为羊水胎粪污染有活力组38例和羊水胎粪污染无活力组39例。结果Ⅲ度羊水胎粪污染新生儿出生后7d,NBNA评分异常率为23.7%。羊水胎粪污染有活力组NBNA评分异常率高于正常对照组(χ2=9.83,P<0.01);羊水胎粪污染无活力组NBNA评分异常率高于正常对照组(χ2=7.01,P<0.01);羊水胎粪污染有活力组NBNA评分异常率也高于羊水胎粪污染无活力组,但差异无显著性意义(χ2=0.309,P>0.05)羊水胎粪污染有活力组、羊水胎粪污染无活力组与正常对照组等3组NBNA的五大项目中比较,羊水胎粪污染有活力组、羊水胎粪污染无活力组两组的行为能力、主动肌张力2项得分均明显低于正常对照组(P<0.01),而羊水胎粪污染有活力组、羊水胎粪污染无活力组两组的行为能力、主动肌张力2项得分差异无统计学意义(P>0.05)。结论对Ⅲ度羊水胎粪污染的新生儿,应重视对新生儿神经行为发育的影响,通过NBNA测定,能早期发现轻微脑损伤的婴儿,对优生优育有重要意义。
Objective To investigate the clinical significance of Neonatal Behavioral Nerve Detection (NBNA) in neonates with grade Ⅲ meconium-stained amniotic fluid. Methods Totally 77 newborn infants with stage III amniotic fluid meconium-stained and 40 full-term healthy newborn infants were subjected to behavioral neurolysis at 7 days after birth. Seventy-three degrees of amniotic fluid meconium-stained newborn infants were divided into amniotic fluid meconium-stained group of 38 patients with active and amniotic-meconium-stained group of 39 patients without activity. Results The degree of abnormality of NBNA score was 23.7% at 7 days after birth in third degree amniotic meconium-stained newborn. The abnormal rate of NBNA score in the amniotic fluid meconium-stained active group was higher than that in the normal control group (χ2 = 9.83, P <0.01). The abnormal rate of NBNA score in the amniotic fluid meconium-stained active group was higher than that in the normal control group (χ2 = 7.01, P <0.01) ); The abnormal rate of NBNA score in amniotic fluid meconium-stained active group was also higher than that in amniotic fluid meconium-stained group, but there was no significant difference (χ2 = 0.309, P> 0.05) Pollution inactivated group and normal control group NBNA three groups of three projects compared to the activity of amniotic fluid meconium staining group, amniotic fluid meconium-free activity group two groups of behavioral skills, active muscle tension scores were significantly lower than the two normal (P <0.01). However, there was no difference between the two groups in activity of amniotic fluid meconium staining and amniotic fluid meconium staining. There was no significant difference in active muscle tone between the two groups (P> 0.05). Conclusion Neonates with amniotic fluid meconium-stained Ⅲ degree should pay attention to the neurobehavioral development of neonate. By NBNA assay, early onset of mild brain injury in infants is important for prenatal and postnatal care.