Hammersmith婴儿神经发育评估联合早期针刺在脑损伤高危儿康复治疗中的应用

白玉沛; 曾姣峰; 李玉杰; 韩美美; 刘珍珍; 吕楠

doi:10.16766/j.cnki.issn.1674-4152.004382

Hammersmith婴儿神经发育评估联合早期针刺在脑损伤高危儿康复治疗中的应用

doi: 10.16766/j.cnki.issn.1674-4152.004382

郑州大学附属儿童医院(河南省儿童医院郑州儿童医院)康复医学科，河南郑州 450000

基金项目:

河南省医学科技攻关联合共建项目 20230212

详细信息

通讯作者:
吕楠，E-mail：lvnan1021@163.com

中图分类号: R493 R729.9
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出版历程
- 收稿日期: 2025-08-22
- 网络出版日期: 2026-04-11

Application of Hammersmith infant neurological examination combined with early acupuncture in the rehabilitation treatment of high-risk infants with brain injury

Department of Rehabilitation Medicine, Children's Hospital Affiliated to Zhengzhou University (Henan Children's Hospital, Zhengzhou Children's Hospital), Zhengzhou, Henan 450000, China

摘要

摘要: 目的目前仍缺乏脑损伤高危患儿早期康复的统一规范。本文探讨Hammersmith婴儿神经发育评估(HINE)联合早期针刺在脑损伤高危患儿康复治疗的应用价值，以期为此类患儿治疗提供依据。方法选取2022年11月—2024年5月郑州大学附属儿童医院收治的88例脑损伤高危患儿，使用计算机生成随机数字表法将患者随机分为常规组和治疗组各44例，经严格筛选纳入2组各42例。常规组行常规康复训练，治疗组行常规康复训练、HINE、早期针刺等，疗程3个月。比较治疗总有效率、运动能力[婴幼儿脑性瘫痪粗大运动功能评价量表(GMFM88)和脑瘫患儿精细运动功能测试量表(FMFM)]、神经功能[血清髓鞘碱性蛋白(MBP)、脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)]、脑血流动力学[脑动脉平均血流速度(Vm)、动脉收缩期峰值流速(Vs)、血管阻力指数(RI)]、并发症。结果治疗组总有效率(95.24%，40/42)高于常规组(76.19%，32/42，χ²=6.222，P=0.013)；治疗后，治疗组GMFM88和FMFM的A区和B区评分、血清BDNF、Vm、Vs高于常规组，血清MBP、NSE、RI低于常规组(P < 0.05)；2组近远期并发症差异无统计学意义(P>0.05)。结论 HINE联合早期针刺有利于提升脑损伤高危患儿康复治疗效果，改善患儿运动发育、促进患儿神经修复和保护、增加患儿脑组织血流灌注。
- 脑损伤 /
- 高危患儿 /
- Hammersmith婴儿神经发育评估 /
- 早期针刺 /
- 康复治疗
Abstract: Objective At present, there is still a lack of unified norms for the early rehabilitation of children at high risk of brain injury. This article explores the application value of Hammersmith Infant Neurological Examination (HINE) combined with early acupuncture in the rehabilitation treatment of infants at high risk of brain injury, with the aim of providing a basis for the treatment of such children in the future. Methods A total of 88 high-risk children with brain injury admitted to Henan Children' s Hospital from November 2022 to May 2024, were selected and randomly divided into the conventional group and the treatment group. Under the strict screening, 42 cases in each group were included. The conventional group received conventional rehabilitation training and the treatment group received conventional rehabilitation training+ HINE combined with early acupuncture treatment, with 3 months of treatment. The total effective rate of treatment, exercise capacity [gross motor function measure (GMFM88) and fine motor function measure (FMFM)], neurological functions [serum myelin basic protein (MBP), brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE)], cerebral hemodynamics [mean cerebral arterial flow velocity (Vm), peak systolic velocity (Vs) of arteries, vascular resistance index (RI)], and complications of the two groups were compared. Results The treatment group had higher total effective rate [95.24% (40/42) vs. 76.19% (32/42), χ²=6.222, P=0.013]. After treatment, the scores of area A and area B of GMFM88 and FMFM, the level of serum BDNF, Vm, and Vs in the treatment group were all higher than those in the conventional group, while serum MBP, NSE, and RI were all lower (P < 0.05). There was no significant difference in short-term and long-term complications between the two groups (P>0.05). Conclusion HINE combined with early acupuncture is beneficial to improving the rehabilitation treatment effect of high-risk infants with brain injury, improving the motor development of children, promoting neural repair and protection of children, and increasing the blood perfusion of brain tissue in children.
- Brain injury /
- High-risk infants /
- Hammersmith infant neurological examination /
- Early acupuncture /
- Rehabilitation therapy

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表 1 2组脑损伤高危患儿一般资料比较

Table 1. Comparison of general data between the two groups of children at high risk of brain injury

组别	例数	性别[例(%)]		出生时体重(x±s，kg)	月龄(x±s，月)	脑损伤高危因[例(%)]
组别	例数	男	女	出生时体重(x±s，kg)	月龄(x±s，月)	1种	2种及以上
治疗组	42	20(47.62)	22(52.38)	1.43±0.39	3.78±1.17	31(73.81)	11(26.19)
常规组	42	23(54.76)	19(45.24)	1.41±0.42	3.95±1.25	29(69.05)	13(30.95)
统计量		0.429^a		0.226^b	0.643^b	0.233^b
P值		0.513		0.822	0.522	0.629
注：^a为χ²值，^b为t值。

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表 2 2组脑损伤高危患儿治疗总有效率比较[例(%)]

Table 2. Comparison of the total effective rate of treatment between the two groups of children at high risk of brain injury [cases (%)]

组别	例数	临床治愈	好转	无效	总有效
治疗组	42	9(21.43)	31(73.81)	2(4.76)	40(95.24)
常规组	42	7(16.67)	25(59.52)	10(23.81)	32(76.19)
注：2组总有效率比较，χ²==6.222，P=0.013。

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表 3 2组脑损伤高危患儿运动能力比较(x±s，分)

Table 3. Comparison of motor ability between the two groups of children at high risk of brain injury (x±s, points)

组别	例数	GMFM88 B区评分		GMFM88 B区评分		FMFM评分A区评分		FMFM评分B区评分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	42	27.43±2.85	40.97±3.69^b	32.07±3.52	47.41±4.23^b	6.14±0.78	13.14±1.26^b	5.43±0.49	15.71±1.52^b
常规组	42	27.58±2.56	33.52±3.44^b	31.96±3.35	39.17±3.59^b	6.03±0.69	9.03±0.88^b	5.40±0.46	10.29±1.06^b
统计量		0.293^a	91.783^c	0.409^a	92.744^c	0.353^a	300.675^c	0.230^a	359.095^c
P值		0.771	< 0.001	0.683	< 0.001	0.725	< 0.001	0.819	< 0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 4 2组脑损伤高危患儿治疗前后神经相关指标比较(x±s)

Table 4. Comparison of neuro-related indicators between the two groups of children at high risk of brain injury before and after treatment (x±s)

组别	例数	MBP(μg/L)		BDNF(ng/mL)		NSE(μg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	42	1.38±0.35	0.92±0.27^b	4.18±0.96	5.23±1.04^b	29.47±5.81	13.02±3.84^b
常规组	42	1.42±0.46	1.08±0.30^b	4.06±0.87	4.71±0.99^b	28.91±7.33	16.19±4.26^b
统计量		0.448^a	6.610^c	0.600^a	5.538^c	0.388^a	12.831^c
P值		0.655	0.012	0.550	0.021	0.699	< 0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 5 2组脑损伤高危患儿治疗前后脑血流动力学指标比较(x±s)

Table 5. Comparison of cerebral hemodynamic indicators between the two groups of children at high risk of brain injury before and after treatment (x±s)

组别	例数	Vm(cm/s)		Vs(cm/s)		RI(μg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	42	60.75±10.56	73.42±6.53^b	83.16±15.96	110.76±9.02^b	0.91±0.19	0.67±0.11^b
常规组	42	61.33±11.08	69.29±8.17^b	82.85±13.55	102.01±12.83^b	0.88±0.17	0.79±0.15^b
统计量		0.246^a	6.983^c	0.096^a	15.247^c	0.763^a	19.564^c
P值		0.807	0.010	0.924	< 0.001	0.448	< 0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 6 2组脑损伤高危患儿近远期并发症发生情况比较[例(%)]

Table 6. Comparison of short-term and long-term complications between the two groups of children at high risk of brain injury [cases (%)]

组别	例数	肌张力异常	发育迟缓	脑性瘫痪	癫痫发作	总发生
治疗组	42	0	1(2.38)	1(2.38)	0	2(4.76)
常规组	42	1(2.38)	2(4.76)	3(7.14)	1(2.38)	7(16.67)
注：2组并发症总发生率比较，χ²=1.991，P=0.158。

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