高压氧治疗新生儿缺氧缺血性脑病远期智能随访

The intelligence of neonates with hypoxic ischemic encephalopathy with hyperbaric oxygen

目的 观察高压氧（Hyperbaricoxygen，HBO）治疗新生儿缺氧缺血性脑病（HIE）的远期智能评估。方法将65例HIE患儿随机分为治疗组和对照组，两组采用相同的常规药物治疗，治疗组则在此基础上于病情稳定后72小时内加用HBO治疗，并通过随访对两组患儿神经系统后遗症发生率及1岁时体格、智能的发育情况加以比较，5～7岁时行韦氏学龄前儿童智力量表（WPPSI）测试，以评价HB0治疗HIE的远期智能康复情况。结果两组神经系统后遗症发生率及1岁时智能发育情况差异均有显著性，而体格发育差异无显著性。5～7岁时WPPSI智力测定，HBO组总智商（FIQ）、语言智商（VIQ）和操作智商（PIQ）高于对照组。结论高压氧治疗新生儿缺氧缺血性脑病可减少神经系统后遗症的发生，改善远期预后，提高智商水平，降低致残率，是提高生存质量行之有效的方法。

Objective To explore the long-time effects of hyperbaricoxygen （HBO） therapy on the promotion of intellectual rehabilitation in infants with hypoxic ischemic encephalopathy（HIE）. Methods Sixty-five infants with HIE were randomly divided into HBO group （n = 33） and control group （n = 32）. All infants were treated with routine therapy, in addition to HBO group with HBO in 72 hours after stabilization once a day. The incidence rate of sequel of nervous system, physical constitution and intelligence at the age of 1 year, and Wechsler Preschool and Primary Scale of Intelligence at the age of 5-7 years were obersved. Results There were significant difference in the incidence rate of sequel of nervous system and intelligence at the age of 1 years in the HBO group, compared with that in control group （P〈0.01）. There was no significantly difference the physical constitution between the two groups. The scores of FIQ, VIQ and PIQ in HBO group were significantly higher than that in control group（P〈0. 05）. Conclusion The incidence rate of sequel of nervous system and intellectual rehabilitation in infants with HIE could be improved withy HBO therapy, which might be benefit to prevent mental retardation.