住院音乐干预对早产儿脑发育的影响

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摘要目的探讨住院音乐干预对早产儿脑发育的影响。方法选取2017年4月～2018年4月佛山市第一人民医院新生儿科收治的60例母亲孕龄≤33周的适于胎龄早产儿为研究对象，采用随机奇偶数字表法将其分为观察组及对照组，每组各30例。两组早产儿均采用常规治疗。在此基础上，对照组采用常规护理干预。观察组在常规护理基础上采用住院音乐干预。比较两组患儿的振幅整合脑电图人均检查次数；比较两组干预第1、2、3周的Burdjalov 评分；比较两组患儿不同矫正胎龄（矫正胎龄33～＜35、35～＜37、37～38 周）的睡眠-觉醒周期时长；比较两组患儿矫正24月龄的盖泽尔评分；比较两组患儿出院时的听力筛查（瞬态诱发耳声发射、听性脑干反应）正常率。结果两组患儿的振幅整合脑电图人均检查次数比较，差异无统计学意义（P＞0.05）。两组患儿干预第2、3周的睡眠-觉醒周期、带宽Burdjalov 评分及Burdjalov 总分均高于本组干预第1周，差异有统计学意义（P＜0.05）。两组患儿干预第2、3周的脑电连续性、下边界振幅Burdjalov 评分与本组干预第1 周比较，差异无统计学意义（P＞0.05）。观察组干预第2周的睡眠-觉醒周期Burdjalov 评分、Burdjalov 总分高于对照组，差异有统计学意义（P＜0.05）。两组患儿干预第2周的脑电连续性、下边界振幅、带宽Burdjalov 评分比较，差异无统计学意义（P＞0.05）。干预第1、3周，两组患儿的睡眠-觉醒周期、脑电连续性、下边界振幅、带宽Burdjalov 评分及Burdjalov 总分比较，差异均无统计学意义（P＞0.05）。观察组矫正胎龄33～＜35、35～＜37、37～38周的睡眠-觉醒周期时长均短于对照组，差异有统计学意义（P＜0.05）。观察组患儿矫正24月龄的个人-社交盖泽尔评估智能发育商评分高于对照组，差异有统计学意义（P＜0.05）。两组患儿矫正24月龄的个人-社交盖泽尔评估智能发育商等级情况比较，差异无统计学意义（P＞0.05）。两组出院时的听力筛查（瞬态诱发耳声发射、听性脑干反应）正常率比较，差异无统计学意义（P＞0.05）。结论住院期间音乐干预对早产儿脑发育成熟短期有促进作用，远期效果需进一步观察。

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关键词 ：音乐干预, 早产儿, 脑发育, 振幅整合脑电图, 盖泽尔

Abstract：Objective To investigate the effect of music intervention in hospital on the brain development of premature infants.Methods A total of 60 premature infants of gestational age of the mother ≤33 weeks and appropriate for gestational age admitted to the Department of Neonatology of the First People′s Hospital of Foshan City from April 2017 to April 2018 were selected as the research subjects.They were divided into observation group and control group by random odd-even number table method,with 30 cases in each group.The preterm infants in both groups received routine treatment.On this basis,the control group used conventional nursing intervention.The observation group was treated with inpatient music intervention on the basis of conventional nursing.The average frequency of amplitude-integrated electroencephalogram was compared between the two groups.Burdjalov scores of the two groups were compared at 1,2 and 3 weeks after intervention.The lengths of sleep-wake cycle were compared between the two groups at different corrected gestational ages (corrected gestational age 33～＜35,35～＜37,37～38 weeks).Gesell scores at 24 months of correction were compared between the two groups.The normal rate of hearing screening (transient induced otoacoustic emission,auditory brainstem response) was compared between the two groups at discharge.Results There was no statistical significance in the average frequency of amplitude-integrated electroencephalogram between the two groups (P＞0.05).The scores of sleep-wake cycle,bandwidth Burdjalov scores and Burdjalov total score of the two groups at the second and third week of intervention were higher than those at the first week of intervention,with statistically significant differences (P＜0.05).The Burdjalov scores of electroencephalogram continuity and lower boundary amplitude of the two groups at the second and third week of intervention were not significantly different from those at the first week of intervention (P＞0.05).The scores of sleep-wake cycle Burdjalov score and Burdjalov total score in the observation group at the second week after intervention were higher than those in the control group,with statistically significant differences (P＜0.05).There were no significant differences in Burdjalov scores of electroencephalogram continuity,lower boundary amplitude and bandwidth between the two groups at the second week after intervention (P＞0.05).At the first and third week of intervention,there were no significant differences in scores of sleep-wake cycle,electroencephalogram continuity,lower boundary amplitude,bandwidth Burdjalov scores and Burdjalov total score between the two groups (P＞0.05).The sleep-wake cycle lengths of corrected gestational age 33-＜35,35-＜37 and 37-38 weeks in the observation group were shorter than those in the control group,and the differences were statistically significant (P＜0.05).The intelligent development quotient score of personal-social Gesell assessment of the observation group at 24 months of correction was higher than that of the control group,and the difference was statistically significant (P＜0.05).There was no significant difference between the two groups in the intelligent development quotient level of personalsocial Gesell assessment at 24 months of correction (P＞0.05).There was no significant difference in the normal rate of hearing screening (transient induced otoacoustic emission,auditory brainstem response) between the two groups at discharge (P＞0.05).Conclusion Music intervention during hospitalization can promote the brain development and maturation of premature infants in the short term,but the long-term effect needs to be further observed.

Key words： Music intervention Premature infant Brain development Amplitude-integrated electroencephalogram;Gesell

引用本文:

卢泳雪；霍惠仪；区嘉欣；邹晓萍；周金玉；何露丝；彭云菊；黄夏纯；母静；严素芬. 住院音乐干预对早产儿脑发育的影响[J]. 中国当代医药, 2021, 28(5): 134-140.
LU Yong-xue HUO Hui-yi OU Jia-xin ZOU Xiao-ping ZHOU Jin-yu HE Lu-si PENG Yun-ju HUANG Xia-chun MU Jing YAN Su-fen. Effect of music intervention in hospital on brain development of premature infants. 中国当代医药, 2021, 28(5): 134-140.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I5/134

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