综合疗程治疗干预对新生儿缺血缺氧性脑病的康复影响

Effect of comprehensive rehabilitation course of treatment interventions for neonatal hypoxic-ischemic encephalopathy

目的:探讨综合疗程治疗干预对新生儿缺血缺氧性脑病(hypoxic-ischemic encephalopathy,HIE)的康复影响。方法:将62例缺血缺氧性脑病新生儿按照治疗方式随机地分为对照组(n=30)与观察组(n=32),对照组采用神经节苷脂(ganglioside,GM-1)进行治疗,观察组在此基础上采用高压氧(hyperbaric oxygenation,HBO)治疗。比较两组临床疗效、体征改变时间、治疗前后血清神经元特异性烯醇(neuron-specific enolase,NSE)水平、运动发育评分、各能区智能发育商评分。结果:(1)经治疗,观察组临床总有效率为90.63%,显著高于对照组(66.67%)(P<0.05);(2)治疗后在意识障碍恢复时间、惊厥停止时间与肌张力正常时间方面,观察组显著小于对照组(P<0.05);(3)治疗后两组患者NSE水平均显著下降,观察组下降幅度大于对照组(P<0.05);(4)治疗后在大运动、语言、精细动作、适应能力与社交行为评分方面,观察组显著高于对照组(P<0.05);(5)观察组治疗后各能区智能发育商(动作能、应物能、应人能及言语能)评分均显著高于对照组(P<0.05)。结论:综合疗程治疗干预能够促进新生儿缺血缺氧性脑病的康复,应在临床上进行推广、应用。

Objective: To investigate the impact of a comprehensive course of rehabilitation treatment interventions for neonatalhypoxic - ischemic encephalopathy ( H IE ). Methods:62 cases of patients with neonatal hypoxic-ischemic encephalopathy were randomlydivided into the control group (n, = 30) and the observation group (n, = 32) according to treating methods. The control group receivedGM-1 for treatment only, and the observation group received hyperbaric oxygenation (HBO) therapy on basis of the control group. Theclinical efficacy and time of clinical signs-changing, serum neuron-specific enolase ( NSE ) levels before and after treatment, scores onmotor development, scores on intelligent developmental quotient (D Q ) in each energy region were compared. Results: (1 ) After treatment,the observation group7s total effective rate was 90. 63% , which was significantly higher than that of the control group(66. 67% )(P < 0 .0 5 ) ; ( 2 ) The changing time of the clinical signs of the observation group (recovery time for consciousness, time for convulsions-stopping, time for muscle tension recovery) after the treatment were significantly lower than the control group (P < 0 . 0 5 ) ;(3 )The NSE level was significantly decreased after treating, and the declining degree of the observation group7s NSE level was significantlygreater than the control group (P < 0 . 0 5 ) ;(4 ) Scores on each dimension ( large movement, language, fine motor, adaptability and socialbehavior) of the motor development of the observation group were significantly higher than the control group(P <0. 05) ;(5 ) Developmentalquotients on each area (action can and should be able to object, one can and capable of speech) of the observation group wereall significantly higher than the control group ( P < 0. 0 5 ). Conclusion : Comprehensive course of treatment interventions can promoteneonatal hypoxic-ischemic encephalopathy rehabilitation, and it should be promoted in the clinical application.