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目的观察高压氧治疗重度新生儿缺氧缺血性脑病(HIE),促进患儿智能康复的近期、远期疗效。方法将同期住院的47例重度HIE患儿随机分为高压氧(HBO)组24例、对照组23例,两组接受相同的常规药物治疗至生后3个月,HBO组自生后8~10d开始接受HBO治疗,10d为1个疗程,每间隔10~15d进行下1个疗程,共4个疗程。两组患儿均按双盲原则,于生后7d、28d行新生儿行为神经(NBNA)测定,2岁时行Bayley婴幼儿发育量表(BSID)测试,于5岁时行韦氏学龄前儿童智力量表(WPPSI)测试,以评价HBO治疗重度HIE的近期与远期智能康复情况。结果HBO组28d时NBNA评分明显高于对照组(P<0.01);2岁时Bayley智力测定,HBO组心理发展指数(MDI)明显高于对照组(P<0.05);5岁时WPPSI智力测定,HBO组总智商(FIQ)和言语智商(VIQ)明显高于对照组(P<0.05)。HBO组智力缺陷发生率为12.5%(3/24),明显低于对照组39.1%(9/23)(P<0.05)。结论HBO不仅可显著提高患儿的近期疗效,且能够明显改善患儿的远期预后,促进其智能康复,防治智力低下。
Objective To observe the short-term and long-term effects of hyperbaric oxygen therapy on severe neonatal hypoxic-ischemic encephalopathy (HIE) and to promote the intelligent rehabilitation of children. Methods Forty-seven patients with severe HIE admitted to hospital during the same period were randomly divided into HBO group (n = 24) and control group (n = 23). The two groups were treated with the same conventional drugs until 3 months after birth. HBO began to receive treatment, 10d for a course of treatment, every interval of 10 ~ 15d for a course of treatment, a total of 4 courses. According to the double-blind principle, both groups of children were measured on neonatal behavioral neurons (NBNA) at 7 days and 28 days after birth, and Bayley Infant Development Scale (BSID) at 2 years old. At 5 years old, Children’s Intelligence Scale (WPPSI) test to assess recent and long-term intelligent rehabilitation of HBO for severe HIE. Results The NBNA score of HBO group was significantly higher than that of the control group at 28 days (P <0.01). The Bayley Intelligence Test at 2 years and the Psychological Development Index (MDI) of HBO group were significantly higher than those of the control group (P <0.05) , FIQ and VIQ in HBO group were significantly higher than those in control group (P <0.05). The incidence of mental retardation in HBO group was 12.5% (3/24), significantly lower than 39.1% (9/23) in control group (P <0.05). Conclusion HBO can not only significantly improve the short-term effect of treatment in children, but also can significantly improve the long-term prognosis of children, promote their intelligent rehabilitation, prevention and treatment of mental retardation.