高压氧联合神经节苷酯治疗缺氧缺血性脑病致新生儿听力损伤的临床观察

Hyperbaric Oxygen Combined with Ganglioside Treatment of Hypoxic Ischemic Encephalopathy of Newborn Hearing Damage Caused by the Clinical Observation

目的:通过观察新生儿缺氧性脑病(HIE)治疗前后脑干听觉诱发电位(BAEP)的变化,研究高压氧(HBO)联合单唾液酸四己糖神经节苷酯钠(GM1)治疗新生儿缺氧缺血性脑病致新生儿听力损伤的临床疗效。方法:HIE患儿108例,随机分成治疗组(常规治疗上加高压氧联合神经节苷酯治疗)78例(轻度HIE58例,中重度HIE20例)和对照组(常规治疗)30例(轻度HIE20例,中重度10例)。在治疗前和出生第3天测试BAEP,并于出生第42天复查BAEP,观察治疗前后脑干听觉诱发电位(BAEP)的变化。结果:对照组轻度HIE治疗前后比较:治疗前后BAEP异常率分别为60%、50%,两者比较差异无统计学意义(P=0.5250)。中重度HIE患儿10例,治疗前后BAEP异常率分别为80.0%(8例)和50.0%(6例),两者比较差异无统计学意义(P=0.1596);治疗组轻度HIE患儿,治疗前后BAEP异常率分别为46.6%(27例),22.4%(13例),两者比较差异有统计学意义(P=0.0062)。中重度HIE患儿治疗前后BAEP异常率分别为75.0%(15例)和35%(7例),两者比较差异有统计学意义(P=0.0110)。结论:高压氧联合神经节苷酯可显著改善患儿BAEP异常率,对于治疗缺氧缺血性脑病致新生儿听力损伤不失为一种积极有效的治疗方法,能有效改善预后,提高患儿生存质量。

Objective:To investigate the HIE neonates before and after treatment of brainstem auditory evoked potentials(BAEP) changes,study of hyperbaric oxygen(HBO) combined with single saliva four sour hexose ganglioside sodium(GM1) treatment of neonatal hypoxic ischemic encephalopathy induced by neonatal hearing injury.Methods:108 children with HIE were randomly divided into the treatment group(conventional treatment with hyperbaric oxygen combined with ganglioside treatment) in 78 patients(58 patients with mild HIE,HIE in 20 cases) and control group(conventional treatment) in 30 patients(20 patients with mild HIE,10 cases).Before treatment and third days after birth and to test the BAEP,born forty-second days to review the BAEP,were observed before and after treatment of brainstem auditory evoked potentials(BAEP) changes.Results:Abnormal BAEP controls and HBO combined with GM1 treatment group after treatment:a control group of 20 cases of children with mild HIE before and after treatment,the abnormal rate of BAEP were 60%,50%,two no significant difference(P=0.5250) in 10 cases of children with HIE before and after treatment,the abnormal rate of BAEP were 80%(8cases) and 50%(n=6),two no significant difference(P=0.1596);the treatment group before and after treatment in children with mild HIE,abnormal rate of BAEP were 46.6%(27 cases),22.4%(n=13),there is significant difference between the two(P=0.0062).In severe HIE patients before and after treatment of the abnormal rate of BAEP were 75%(n=15) and 35%(n=7),there is significant difference between the two(P=0.0110).Conclusion:Hyperbaric oxygen combined with ganglioside treatment can significantly improve the children the abnormal rate of BAEP,for the treatment of hypoxic ischemic encephalopathy induced by neonatal hearing impairment is regarded as a kind of active and effective treatment,can effectively improve the prognosis,improve the patients quality of life.