缺氧并黄疸新生儿行为神经评分及发育商随访观察

Neonatal behavioral neurological grade in neonates with hypoxia jaundice and following up and observation of development quotient

目的:探讨缺氧并黄疸新生儿对其行为神经及发育商的影响。方法:将收治的高危新生儿68例分为缺氧并黄疸组35例及单纯重度缺氧组33例,分别采用新生儿20项行为神经评分法(NBNA)测试。两组均采用脑细胞代谢激活剂治疗,并对2组生后6、12、24个月龄时的发育商进行随访观察。结果:缺氧并黄疸组NBNA总分及其评分项目中的行为能力、主动肌张力明显高于单纯重度缺氧组,P<0.01,有极显著性差异;生后6、12、24个月龄时的发育商缺氧并黄疸组明显高于单纯重度缺氧组,P值均<0.01,有极显著性差异。结论:缺氧并黄疸可减轻缺氧对大脑损害程度,并可提高NBNA评分及发育商,重视缺氧并黄疸新生儿的早期胆红素检测,把握好黄疸的最佳干预时机,可适当减少神经系统对其的损伤。

Objective： To study the effects on the behavioral neurological and development quotient in neonates with hypoxia jaundice. Methods： 68 cases of high risk newborns were divided into 2 groups, among which 35 cases of neonates with hypoxia jaundice and 33 cases of neonates with acute hypoxia. Neonatal Behavioral Neurological Assessment was conducted in 2 groups. And the following up and observation of development quotient at 6, 12 and 24 months were compared between the groups. Results： The behavioral ability of the group of neonates with hypoxia jaundice had significant difference from that of the group of neonates with acute hypoxia, and the situation of control ability, thumb adduction was much better than that of the group of neonates with acute hypoxia （P 〈 0. 01 ） ; The development quotient at 6, 12, and 24 months in the group of neonates with hypoxia jaundice were significantly higher than those in the group of neonates with acute hypoxia （t =8. 406, 5. 477, 3. 710） （ all P 〈0. 01） . Conclusion： Serious anoxia complicating jaundice could reduce the damage of anoxia to cerebrum, enhance NBNA and development quotient. Paying more attention to the early observation of bilirubin in neonates with hypoxia jaundice and determining the optimal opportunity of clinical intervention can reduce the harm to the nerve system.