高压氧治疗早产儿缺血缺氧性脑病近远期疗效及安全性调查

The Short-term and Long-term Effect of Hyperbaric Oxygen on Premature Infants with Hypoxic-ischemic Encephalopathy and the Safty Investigation

目的：回顾性总结高压氧综合治疗33例早产、低出生体重儿缺血缺氧性脑病的近期及远期疗效，并对其安全性加以调查总结，提出对早产、低出生体重儿进行高压氧治疗应该掌控的原则及应该吸取的教训。方法：分析临床资料，在临床常规治疗的基础上，采用婴儿高压氧舱，治疗压力0．13MPa，每天一次，每次60min，舱内氧浓度72％～75％，平均每例治疗9．6次。治疗结束时进行近期疗效评判；随访各例患儿到7岁时进行远期疗效评判，并进行眼底、头颅CT等检测。结果：经高压氧综合治疗，全部33例患儿均临床痊愈出院。高压氧治疗近期总有效率达96．7％（32／33）；远期随访发现1例死亡，另有5例重度缺血缺氧性脑病患儿留有后遗症，轻、中度患儿和其余的重度惠儿全部康复。32例患儿头颅CT复查见脑萎缩1例，其它31例均未发现异常。未发现早产儿视网膜病变的发生。结论：高压氧治疗早产儿缺血缺氧性脑病的近期及远期疗效显著，但鉴于国内外对视网膜病变所做出的大量研究，虽然本组患儿未出现相关并发症，仍必须原则上禁止使用高压氧为早产、低出生体重儿进行治疗。

Objective ： According to reviewing and summing up the short - term and long - term effect of hyperbaric oxygen therapy on 33 premature and underweight infants with hypoxic - ischemic encephalopathy （ HIE ）, as well as the safty investigation, the study was to recommend some principles and experience of hyperbaric oxygen therapy. Method： Based on analyzing the clinical data and the primary therapy, infant hyperbaric oxygen chamber was used, the pressure was 0. 13MPa, once a day, 60rain for once, the content of oxygen was between 72% and 75%, and 9.6 times for every infant on average. Short - term effect was evaluated after the therapy and long -term effect was evaluated during the later seven years. Eyeground brain and so on were checked. Result： All 33 infants recovered and leaved hospital after hyperbari , CT for c oxygen therapy. The short - term efficiency is 96.7% （32/33）, however, during the long - term observation, one died and five with serious HIE infants had sequelas, all with slight or moderate HIE and the rest with serious HIE recovered completely, One infant in 32 has cerebral atrophy in CT for brain and the other are normal. Retinopathy of prematurity （ ROP ） has not been discovered. Conclusion： The short - term and long - term effect of Hyperbaric Oxygen on Premature Infants with Hypoxie - ischemic Encephalopathy was obvious.There was no related side - effect in this study, but according to the research of ROP made in home and abroad, in principle, Hyperbaric Oxygen Therapy should be forbidden in premature and underweight infants.