a material and research methods

The inspection program included following methods:

1). Clinico-Anamnestichesky. On everyone observed novorozhyodennogo the child questionnaire specially developed by us in which data of the akushersko-gynecologic anamnesis have been reflected, somatic pathology of mother has been got; features of a clinical current bere -

mennosti and sorts, ways of a delivery, application obstetric poyosoby.

Data of clinical survey in a maternity home, otyorazhajushchee the general condition of the newborn (an estimation on scale Apgar, poyokazateli physical development and their dynamics, an estimation of degree of a maturity, presence of transitional conditions of the period novorozhdennosti, carrying out of reanimation actions etc.) were considered.

The special attention was given to an estimation of the neurologic status novoyorozhdennogo (a pose, cry, emotions, a muscle tone, spontaneous dvigatelyonaja activity, sphere of instinctive reflexes, presence of pathological symptoms, focal semiology, a tremor, regurgitations, etc.). In dinamiyoke within the first year of a life on a pediatric site at all children the neurologic status, with definition focal mikroyosimptomatiki, meningeal reflexes, research of impellent and vegetatively-trophic spheres was estimated.

The special attention was taken away to an objective estimation of a muscle tone on validnoj to a scale spastichnosti Eshuorta (Modified Ashworth Scale, 1986) (table 2.2.1.).

Table 2.2.1.

Modified scale Eshuorta, 1986

All surveyed children have been tested on special ameriyokanskim to questionnaires KID-R and R-CDI, adapted for Russia Sankt - the Petersburg institute of an early intervention in 1991.

The general clinical and neurologic inspection was supplemented with data nejrosonograficheskogo, ophthalmologic and rentgenologiyocheskogo researches.

2). The ECHO - encephalography. It was spent - on an echoencephaloscope “ЭХО-12“ by the standard technique in a dorsal decubitus with head turn.

Following indicators were analyzed: size ' shifts sreyodinnyh structures (M - the ECHO), width of III ventricle, ventrikuljarnyj inyodeks, expression lateralnyh signals.

3); Ophthalmologic research. For the purpose of revealing of a pathology, organs зрения* all children have been examined by the oculist; special attention; it was given to an eyeground condition.

4). nejrosonografija. nejrosonografija it was spent by the standard polyitem technique to all surveyed children in the beginning of a course of regenerative correction and on the therapy termination, through the big fontanel on digital dopplerograficheskom spectral, whether - also colour nejno-konveksnom the scanner “Logy - 700 PRO Series” (Japan), with polucheniyoem images in sagittalnoj and face-to-face planes.

For the analysis sonograficheskih, signs estimated the sizes osnovyonyh structures of a brain and ventrikulometricheskih parametres; hayorakter and the sizes of taped pathological formations; degree definition ehogennosti and ehostruktury a brain.

Special attention to turned th following changes: puffiness payorenhimy a brain, individual or plural cysts; sosudiyostogo plexuses of lateral ventricles of a brain, a hemorrhage, sites dvuyostoronnego periventrikuljarnogo obyzvestlenija, or lejkomaljatsii, vyyorazhennaja or a moderate dilatation of ventricular system of a brain (passivyonaja a hydrocephaly), asymmetry of lateral ventricles, atrophic, rubyotsovye changes, necrosis sites.

5). A X-ray inspection technique. A craniography proyovodilas by the standard technique in a direct and lateral projection. The skull form, a condition of osteal seams, a condition “turetsyokogo saddles” were estimated.

The backbone X-ray inspection was spent with use of classical packings (in direct and lateral projections), in necessary cases special packings were applied: through a mouth, with functional assays, at a flexion and a head extension.

The analysis spondilogramm has been based on standard priznayokah, conditionally parted on 3 groups (M.K.Mihajlov, 1985): 1. priyoznaki shifts of vertebra; 2. Deforming signs; 3. Indirect signs of damage of a backbone.

6). An estimation of psychomotor development on scales of development KID-R and R - CDI. The estimation of psychomotor development, besides clinical survey, was spent under the special adapted program “Scales razviyotija”, developed by the St.-Petersburg institute early vmeshayotelstva.

Standard questionnaires KID-R and R-CDI (containing 252 and 216 voproyosov accordingly) are intended for an estimation of development of children (at the age from 2 till 16 months and from 12 till 36 months accordingly). Questionnaires zayopolnjalis parents of children participating in research, then provoyodilas data processing by means of the special program on persoyonalnom the computer. Scales have been filled by parents of children.

The conclusion contained the information on actual development rebenyoka on following parametres: kognitivnaja activity, impellent development, speech development, skills of self-service, socialisation. SoYOglasno to results of questioning, the child was considered lagging behind in razviyotii if the estimation on a full scale differed from age norm more, than on - 1,8 root-mean-square deviations.

2.3.