魏国俊

[摘要] 目的 探討健康教育联合口腔运动指导对脑瘫高危儿的影响。 方法 回顾性分析2013年1月～2015年2月陕西省汉中市三二〇一医院收治的脑瘫高危儿212例的临床资料，依据护理措施不同进行分组，对照组（常规护理）100例，观察组（健康教育联合口腔运动指导）112例。观察两组脑瘫高危儿护理前后进餐时间固定、进餐地点固定、进餐环境安静、强迫喂食行为、言语性鼓励和情感交流评分和运动发育水平、智能发育水平评分，记录两组脑瘫高危儿运动落后、精神发育迟缓、脑瘫的发生率。 结果 两组护理前进餐时间固定、进餐地点固定、进餐环境安静、强迫喂食行为、言语性鼓励和情感交流评分和运动发育水平、智能发育水平评分比较，差异均无统计学意义（P > 0.05），护理后两组患儿上述各项评分均显著高于护理前，且观察组明显高于对照组，差异均有统计学意义（P < 0.05）。观察组运动落后、精神发育迟缓、脑瘫的发生率均显著低于对照组，差异均有统计学意义（P < 0.05）。 结论 健康教育联合口腔运动指导可以提高脑瘫高危儿喂养行为评分，改善脑瘫高危儿运动发育、智能发育，降低不良事件发生率，值得临床推广应用。

[关键词] 健康教育；口腔运动指导；脑瘫高危儿

[中图分类号] R473.72 [文献标识码] A [文章编号] 1673-7210（2016）11（b）-0162-04

[Abstract] Objective To investigate the influence of health education combined with oral exercise guidance for high-risk infants with cerebral palsy. Methods The clinical data of 212 cases of high-risk infants with cerebral palsy in 3201 Hospital of Hanzhong City from January 2013 to February 2015 was analyzed retrospectively， they were divided into two groups by different nursing intervention， with 100 cases in control group （routine nursing） and 112 cases in observation group （health education compared with oral exercise guidance）. The mealtimes fixed， eating place fixed， dining environment quiet， forced feeding behavior， encourage verbal and affective interaction score， motor development level score， smart growth level score of two groups before and after nursing were observed. The movement behind， mental retardation， cerebral palsy rate of two groups were recorded. Results The mealtimes fixed， eating place fixed， dining environment quiet， forced feeding behavior， encourage verbal and affective interaction score， motor development level score， smart growth level score of two groups before nursing had no significant differences （P > 0.05）， the scores above of two groups after nursing were higher than those before nursing， and the observation group was higher than the control group， the differences were statistically significant （P < 0.05）. The incidence of movement falling behind， mental retardation， cerebral palsy of observation group was lower than the control group， the differences were statistically significant （P < 0.05）. Conclusion Health education combined with oral exercise guidance can increase the feeding behavior score of high-risk infants with cerebral palsy， improve the motor development， smart growth of high-risk infants with cerebral palsy， decrease the incidence of adverse events， which is worthy of clinical promotion and application.

[Key words] Health education； Oral exercise guidance； High-risk infants with cerebral palsy

脑瘫高危儿是指具有脑瘫高危病史的患儿，其形成原因比较复杂，主要和早产、低出生体重、缺血缺氧性脑病、宫腔内感染、核黄疸、产伤等因素密切相关，会造成远期的智能水平降低和脑瘫等严重的并发症[1-2]。脑瘫高危儿早期脑组织出现不同程度的损伤，可能对患儿口腔运动和进食技能造成影响，从而造成脑瘫高危儿比普通婴幼儿更加难喂养，这就决定了有效的临床护理措施可以提高患儿的喂养水平[3-4]。近年来针对脑瘫高危儿临床护理的研究比较多，但是缺乏健康教育联合口腔运动指导对脑瘫高危儿应用效果的报道[5-6]。本……