早期综合康复联合穴位按摩对缺氧缺血性脑病患儿智力发育、生长发育和血清脑组织损伤标志物的影响

Effects of Early Comprehensive Rehabilitation Combined with Acupoint Massage on Intellectual Development,Growth and Development and Serum Brain Tissue Damage Markers in Children with Hypoxic-ischemic Encephalopathy

目的:探讨早期综合康复联合穴位按摩对缺氧缺血性脑病(HIE)患儿智力发育、生长发育和血清脑组织损伤标志物的影响。方法:选取2016年1月-2021年12月期间西安医学院第二附属医院收治的126例HIE患儿作为观察对象。根据双色球法将患儿分为对照组和观察组,其中对照组63例,在常规治疗基础上联合早期综合康复;观察组63例,在常规治疗基础上接受早期综合康复联合穴位按摩。对比两组患儿临床症状恢复时间、智力发育、生长发育、神经系统后遗症发生率、神经功能和血清脑组织损伤标志物变化。结果:观察组的原始反射、肌张力、意识、可吸吮、眼部运动功能恢复时间及呼吸衰竭纠正时间均短于对照组(P<0.05)。两组干预1个月后体质量、身高、摄入奶量较干预前升高,且观察组的变化大于对照组(P<0.05)。两组干预1个月后精细运动、大运动、适应性、语言及社交能力较干预前升高,且观察组的变化大于对照组(P<0.05)。两组干预1个月后神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、S100β蛋白较干预前下降,新生儿神经行为(NABA)评分较干预前升高,且观察组的变化大于对照组(P<0.05)。观察组神经系统后遗症发生率较对照组低(P<0.05)。结论:早期综合康复联合穴位按摩可促进HIE患儿智力发育、生长发育,减轻脑损伤,降低神经系统后遗症发生风险。

Objective: To explore the effects of early comprehensive rehabilitation combined with acupoint massage on intellectual development, growth and development and serum brain tissue damage markers in children with hypoxic-ischemic encephalopathy(HIE). Methods: 126 cases of children with HIE who were admitted to our hospital from January 2016 to December 2021were selected as the observation objects. According to the double color ball method, the children were divided into control group and observation group, of which 63 cases in the control group, they were combined with early comprehensive rehabilitation on the basis of routine treatment. 63 cases in the observation group, they were received early comprehensive rehabilitation combined with acupoint massage on the basis of routine treatment. The clinical symptom recovery time, intellectual development, growth and development,incidence of neurological sequelae, neurological function and serum brain tissue damage markers changes were compared between the two groups. Results: The original reflex, muscle tension, consciousness, sucking, recovery time of eye motor function and correction time of respiratory failure in the observation group were shorter than those in the control group(P<0.05). 1 month after intervention, body weight, height and milk intake in two groups were higher than those before intervention, and the changes in observation group were greater than those in control group(P<0.05). 1 month after intervention, fine motor, gross motor, adaptability, language and social ability in two groups were higher than those before intervention, and the changes in observation group were greater than those in control group(P<0.05). 1 month after intervention, neuron specific enolase(NSE), myelin basic protein(MBP) and S100β protein in two groups decreased compared with those before intervention, and neonatal behavioral neurological assessment(NABA) score increased compared with that before intervention, and the changes in observation group were greater than those in control group(P<0.05). The incidence of neurological sequelae in observation group was lower than that in control group(P<0.05). Conclusion: Early comprehensive rehabilitation combined with acupoint massage can promote intelligence development, growth and development of children with HIE,reduce brain injury, and reduce the risk of neurological sequelae.