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目的研究早期干预联合神经节苷脂(GM1)治疗新生儿缺氧缺血性脑病(HIE)的临床疗效以及对患儿预后的影响。方法将115例中度HIE患儿随机分为对照组、早期干预组和联合治疗组。对照组给予常规治疗,早期干预组和联合治疗组在常规治疗基础上进行视、触、听觉刺激、运动刺激以及前庭功能训练至6个月,联合治疗组除上述治疗,给予GM1。所有病例均于3、6月龄时进行智能发育随访和检测。结果日龄15、30 d时早期干预组与联合治疗组的NBNA评分经统计学比较,差异有统计学意义(P<0.05),且两组均高于对照组(P<0.05)。三组患儿的3、6月龄智力发育指数(MDI)和运动发育指数(PDI)比较差异有统计学意义,联合治疗组最高,早期干预组次之,对照组最低(P<0.05)。结论早期干预有助于HIE患儿智能发育,改善HIE预后。在早期干预基础上联合GM1治疗对改善患儿预后有一定协同作用。
Objective To investigate the clinical efficacy of early intervention combined with gangliosides (GM1) in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE) and its effect on the prognosis of children. Methods One hundred and fifteen patients with moderate HIE were randomly divided into control group, early intervention group and combined treatment group. The control group was given conventional therapy. The early intervention group and the combination therapy group were given visual, touch, auditory stimulation, exercise stimulation and vestibular function training for 6 months on the basis of routine treatment. The combination therapy group was given GM1 in addition to the above treatment. All cases were smart developmental follow-up and detection at 3, 6 months of age. Results The NBNA score of the early intervention group and the combination therapy group at 15 and 30 days of age was statistically significant (P <0.05), and both groups were higher than the control group (P <0.05). There was significant difference in mental development index (MDI) and motor development index (PDI) between 3 and 6 months old in the three groups. The combined treatment group was the highest, followed by the early intervention group and the lowest in the control group (P <0.05). Conclusion Early intervention is helpful to the intelligence development of HIE children and to improve the prognosis of HIE. In the early intervention based on the combination of GM1 treatment to improve the prognosis of children have some synergy.