新生儿缺氧缺血性脑病早期综合干预临床分析

Early comprehensive intervention for hypoxic ischemic encephalopathy

目的：探讨新生儿缺氧缺血性脑病（HIE）早期综合干预治疗的临床疗效。方法：选取我科2014年3月～2015年5月收治的HIE患儿作为研究对象，随机分为观察组与对照组，对照组给予常规补液、纠正电解质紊乱、维持血糖、控制惊厥、降颅压、激素、甘露醇、维生素类、防止感染等治疗，观察组在对照组基础上结合早期综合干预康复治疗，治疗后观察两组血清相关指标、神经行为（NBNA）测定及发育商（DQ）评估。结果：观察组血清天门冬氨酸氨基转移酶（AST）、乳酸脱氢酶（LDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）水平低于对照组，具有统计学意义（P〈0．05），血清钙（Ca）水平两组比较无统计学意义（P〉0．05）；观察组NBNA评分优于对照组，差异有统计学意义（P〈0．05），观察组在3、6、12、18、24个月龄DQ值明显超过对照组，两组比较具有统计学意义（P〈0．05）。结论：对HIE患儿给予早期综合干预康复治疗，可有效改善患儿血清心肌酶水平，提高治疗效果，改善患儿智力和运动发育水平及DQ，从而提高患儿生存质量。

Objective： To explore the clinical efficacy of the early comprehensive intervention on hypoxic ischemic encephalopathy （HIE）. Methods： HIE children who were admitted in our department from March, 2014 to May, 2015 were included in the study and random- ized into the observation group and the control group. The patients in the control group were given routine fluid infusion, electrolyte disturb ance correcting, blood sugar maintaining, convulsion controlling, intracranial pressure reducing, hormone, mannitol, vitamins, infection pre- venting, and other treatments. Based on the treatments given in the control group, the patients in the observation group were given the com- prehensive intervention. After treatment, the serum related indicators, NBNA, and DQ in the two groups were observed. Results.. The levels of serum AST, LDH, CK, and CK--MB in the observation group were significantly lower than those in the control group （P〈0. 05）, while the difference of serum Ca level between the two groups was not statistically significant （P〈0.05）. NBNA score in the observation group was significantly higher to that in the control group （P〈0.05）. DQ values at 3, 6, 12, 18, and 24 months in the observation group were signifi- cantly higher than those in the control group （P〈0. 05）, Oonclusions： Early comprehensive intervention can effectively reduce the serum cardi ac enzyme levels, increase the therapeutic effect, improve the intelligence and motor development levels and DQ and enhance the living quali ties.