The Impact Of Early Nursing Intervention On Cognitive Function Of Children With Infantile Spasm

ObjectiveTo understand the current cognitive status of infants with infantile spasm and explore the impact of early nursing intervention on cognitive development and twitch control of infants with infantile spasm.MethodsFrom January 2017 to December 2017,42 infants with infantile spasm were admitted to the department of neurology of Zhejiang University Affiliated Children's Hospital,which is a third-grade first-class hospital in Zhejiang Province.Patients were divided into two groups,with 21 cases in each group.Both groups received ACTH treatment in the hospital,and Complete the Gesell cognitive assessment before treatment.The control group was treated with small doses and short courses of ACTH plus routine nursing.Patients in the control group were given treatment other than drugs,such as movements,visual,auditory,language and upper limb function training,which is the basis of early nursing intervention.After the patients were discharged following inpatient treatment,statistics were collected by research personnel in the hospital after 2 weeks,1 month,3 months and 6 months post discharge respectively,via telephone,Internet and by the outpatient follow-up rehabilitation team of the hospital.The control and cognitive improvement of the two groups were observed after 6 months.SPSS 23.0 was used for statistical software to analyze the data,the measurement data were described by x ±s and the count data were measured by chi-square test.p<0.05 was statistically different.Results1.Generally,children with infantile spasm have delayed cognitive development;among the 42 children,only 4 had normal or normal margins,and the remaining 38 had different levels of abnormal cognitive development.Gesell cognitive evaluation for adaptability had the lowest score while the highest score was in the language aspect.2.After 14 days of ACTH treatment and intervention,effectiveness of treatment in the control group was 90.5%(19/21)and 85.7%(18/21)in the experimental group.The effectiveness of treatament in the control group was 76.2%(16/21)and 81%(17/21)in the experimental group during the 6-month follow-up.The difference was not statistically significant(p>0.05).3.During the 6-month follow-up,18 people in the control group completed the cognitive development assessment,which was significantly improved in the fine motor and individual/social aspect,with statistically significant differences(p<0.05).No significant differences were found in the adaptive,movement and language aspect(p>0.05).In the experimental group,20 people completed the cognitive development assessment,showing significant improvement in adaptability,large movement,fine movement and individual/social aspect,with statistically significant difference(p<0.05),but no name improvement in language aspect,was observed,thus no significant difference was noted(p>0.05).Conclusion1.Generally,children with IS have delayed cognitive development,and Gesell cognitive evaluation for adaptability had the lowest score while the highest score was in the language aspect.2.Low-doses and short-courses of ACTH treatment in IS patients is effective in controlling convulsion in children with IS.3.Early nursing intervention can improve cognitive development,with significant improvement in adaptability.There was no significant difference between control group and control group without early intervention,and it is strongly recommended on a preventive basis.