不同时间窗早期干预新生儿缺氧缺血性脑病对其预后的影响

To Analysis the Influence of Prognosis for Intervention by Different Time Window on the Neonatal Hypoxic Ischemic Encephalopathy

目的:分析不同时间窗早期干预对新生儿缺氧缺血性脑病预后的影响,为降低患儿后遗症的发生提供科学依据。方法:回顾性分析我院收治的105例中重度HIE患儿,根据患儿就诊时间分为Ⅰ组(出生后6h内)、Ⅱ组(6～24h)、Ⅲ组(>24h)。每组患儿均给予相同的综合支持对症治疗。于患儿出院后3、6、12月龄来院复诊时评价其神经系统发育程度。结果:Ⅰ、Ⅱ、Ⅲ组患儿在12月龄时的智力发育指数分别为90.52±9.18、82.38±9.47、80.63±9.21;Ⅰ、Ⅱ、Ⅲ组患儿在12月龄时的运动发育指数分别为99.27±10.28、87.29±9.18、85.34±11.37。3组患儿在治疗后的MDI、PDI在3个时间点的变化均有统计学意义(P<0.05),Ⅰ组患儿的MDI、PDI水平高于Ⅱ组、Ⅲ组患儿,差异均有统计学意义(P<0.05),但Ⅱ组患儿和Ⅲ组患儿比较,其MDI、PDI水平差异均无统计学意义(P>0.05)。结论:出生后6h内可能是HIE患儿的最佳治疗时间窗。

Objective： To analysis the influence of prognosis for intervention by different time window on the neonatal hypoxic ischemic encephalopathy,in order to provide scientific basis for reduce the occurrence of sequela. Methods： 105 patients with severe HIE who treated in our hospital were retrospective analysised, divided into group I （born after 6h）, group Ⅱ（6～24h）, group Ⅲ（〉24h）according to treatment time of children. Each group of patients were given the same comprehensive symptomatic treatment. In 3,6,12months of children after leaving hospital were measured its nervous system development. Results： The mental development index of Ⅰ,Ⅱ,Ⅲ group children at 12 months age were 90. 52±9. 18,82. 38±9. 47,80. 63±9. 21;the physical development index of Ⅰ,Ⅱ,Ⅲ group children at 12 months age were 99.27±10. 28,87.29±9.18,85. 34±11.37. The MDI, PDI levels at 3 point time changes of 3 groups patients after treatment were statistically significant （P〈0. 05）, the MDI, PDI level of group Ⅰ children were higher than group Ⅱ, group Ⅲ patients, the differences were statistically significant （ P〈0. 05）, but the MDI, PDI levels of group Ⅱ and group Ⅲ were comparied, there were no significant differences （P〉0. 05）. Conclusion.. After the birth of 6h may be the best treatment time window for HIE patients.