早期干预管理在高压氧治疗新生儿缺氧缺血性脑病中的效果

Effect of Early Intervention Combined with Hyperbaric Oxygen in the Treatment of Neonatal Hypoxic Ischemic Encephalopathy

目的:探讨早期干预管理在高压氧治疗新生儿缺血缺氧性脑病(HIE)治疗中的应用效果。方法:选择本院2009年7月-2014年11月确诊的78例患儿为观察对象,采用随机数字表法将其分为两组,干预组38例,对照组40例。两组患儿均行"三项支持,三项对症"常规治疗,干预组在对照组治疗的基础上行高压氧治疗,并给予早期干预管理。观察比较两组新生儿神经行为评分(NABA评分)情况、临床表现恢复时间、死亡率情况及不良反应。结果:干预组患儿肌张力、意识、原始反射的恢复情况均优于对照组,差异均有统计学意义(t=2.583,2.292,2.381;P=0.025,0.029,0.028)。治疗后7、30 d时两组患儿NABA评分均较治疗前有所改善,但干预组效果更佳,比较差异均有统计学意义(P<0.05)。干预组治疗有效率为92.10%,高于对照组的72.50%,两组比较差异有统计学意义(X2=5.086,P<0.05),两组均未出现不良反应及患儿死亡。结论:早期干预管理在高压氧治疗新生儿缺氧缺血性脑病中的应用效果显著,能促进脑发育,提高缺氧缺血性脑病的预后作用,安全可靠值得推广。

Objective：To investigate the effect of early intervention combined with hyperbaric oxygen in the treatment of neonatal hypoxic ischemic encephalopathy（HIE）.Method：Seventy-eight children admitted to our hospital from July 2009 to November 2014 were selected as the objects and were divided into control group（n=38） and intervention group（n=40） according to the random number table,two groups were recieved＂three support and three symptomatic＂treatment,the intervention group was treated with early intervention combined with hyperbaric oxygen on the basis of conventional therapy.The clinical manifestations of neonatal neurological behavior score（NABA score）,recovery time,mortality rate and the adverse reactions of two groups were observed.Result：The recovery of muscular tension,consciousness,and original reflex of intervention group were better than control group,the differences were statistically significant（P〈0.05）.After 7 and 30 days of the treatment,the NABA scores in both of the two groups improved than before,the intervention group of that was better than control group,the differences were statistically significant（P〈0.05）.The effective rate of the intervention group was 92.1%,which was better than 72.50% of the control group,the difference was statistic significant（ X^2=5.086,P〈0.05）.There was no adverse reaction or children death in two groups.Conclusion：Early intervention combined with hyperbaric oxygen therapy for the treatment of HIE can promote development of brain,improve the prognosis of neonatal hypoxic ischemic encephalopathy,which is safe and reliable,it is worthy of promoting.