早期干预联合神经节苷脂治疗对新生儿缺血缺氧性脑病的疗效及预后

Therapeutic Effect and Prognosis in Early Behavioral Intervention Combined with Ganglioside for Neonates with Hypoxic Ischemic Encephalopathy

目的研究早期干预联合神经节苷脂(GM1)治疗新生儿缺氧缺血性脑病(HIE)的临床疗效以及对患儿预后的影响。方法将115例中度HIE患儿随机分为对照组、早期干预组和联合治疗组。对照组给予常规治疗,早期干预组和联合治疗组在常规治疗基础上进行视、触、听觉刺激、运动刺激以及前庭功能训练至6个月,联合治疗组除上述治疗,给予GM1。所有病例均于3、6月龄时进行智能发育随访和检测。结果日龄15、30 d时早期干预组与联合治疗组的NBNA评分经统计学比较,差异有统计学意义(P<0.05),且两组均高于对照组(P<0.05)。三组患儿的3、6月龄智力发育指数(MDI)和运动发育指数(PDI)比较差异有统计学意义,联合治疗组最高,早期干预组次之,对照组最低(P<0.05)。结论早期干预有助于HIE患儿智能发育,改善HIE预后。在早期干预基础上联合GM1治疗对改善患儿预后有一定协同作用。

Objective To study early intervention combined with ganglioside 1 （GM1） in clinical treatment and prognc,ses of neonates with hypoxic - ischemic encephalopathy （HIE）. Methods One hundred and fifteen neonates with moderate HIE were randomly divided into control group, early intervention group and combined therapy group. Control group received routine treatment. Early intervention group and combined therapy group were given early intervention on vision, thigrnesthesia, audition, motion, and vestibular function for 6 months in addition to the routine treatment. Combined therapy group received GM1 besides all above mentioned therapy. Intelligence development of all neonates was followed - up and detected at 3 and 6 months after the intervention. Results There were statistically significant differences in the scores of neonatal behavioral and neuro- logical assessment （NBNA） of neonates at 15 and 30 days after birth between early intervention group and combined therapy group （P 〈 0.05） ; moreover, the scores of above - mentioned two group were all higher than those of control group （ P 〈 0.05）. There were statistically significant differences in the scores of mental developmental index （MDI） and psychomotor developmental index （PDI） of neonates at 3 and 6 months after birth among the three groups （P〈0.05）, and the scores of combined therapy group were the highest, followed by early intervention group and control group. Conclusions Early intervention is conducive to promoting the intelligence development of HIE neonates and improving their prognoses. The therapy of early intervention combined with GM1 may act synergistically in the prognoses of HIE neonates.