高压氧联合早期干预治疗新生儿缺血缺氧脑病及疗效评价的研究

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目的探讨高压氧对缺血缺氧脑病(HIE)新生儿神经行为测试的影响。方法选取70例缺血缺氧脑病患儿,男孩37例,女孩33例,随机分成实验组和对照组各35例,两组患儿性别、分娩方式、围产期情况、父母年龄、文化程度、职业经济状况以及居住环境相似,实验组胎龄(34.70±2.26)月,出生体重(2.38±0.60)kg,Apgar评分(4.60±1.80)分,对照组胎龄(35.65±1.96)月,出生体重(2.68±0.82)kg,Apgar评分(4.86±1.46)分,两组差异无统计学意义;实验组35例新生儿通过高压氧和触、听、视觉训练进行早期干预,对照组常规触、听、视觉训练,对两组新生儿分别于1、3、6、12、24月龄时进行智力发育指数(MDI)和运动发育指数(PDI)检测。结果实验组MDI在治疗后明显升高,3、6月时增长最快,12月达高峰,24月与12月对比差异无统计学意义;对照组1~24个月内存在升高趋势,但是升高数值明显低于实验组,且6月后升高趋势明显减小;PDI在实验组治疗后明显升高,6、12月时增加最快,24月时达高峰;对照组也在3、6月时出现增高,12月达高峰,12~24个月间无明显升高;但增长幅度明显小于实验组相应月份增长值。结论高压氧早期干预有利于缺血缺氧患儿生长发育,智力发育指数(MDI)和运动发育指数(PDI)检测可监测患儿发育状况。 Objective To investigate the effect of hyperbaric oxygen on neurobehavioral testing in neonates with hypoxic-ischemic encephalopathy (HIE). Methods Seventy children with hypoxic-ischemic encephalopathy were selected, including 37 boys and 33 girls, which were randomly divided into experimental group and control group (35 cases each). The gender, mode of delivery, perinatal status, parents’ age, educational level , The occupational economic status and the living environment were similar. The gestational age (34.70 ± 2.26) months, birth weight (2.38 ± 0.60) kg, Apgar score (4.60 ± 1.80) in the experimental group and 35.65 ± 1.96 Body weight (2.68 ± 0.82) kg, Apgar score (4.86 ± 1.46) points, no significant difference between the two groups; experimental group of 35 newborns by hyperbaric oxygen and touch, listening, visual training for early intervention, the control group conventional touch, Hearing and visual training. The mental development index (MDI) and motor development index (PDI) were measured at 1, 3, 6, 12 and 24 months of age respectively. Results In the experimental group, the MDI increased significantly after treatment, the fastest increase in 3 and 6 months, the peak in December, the difference between 24 and December was not statistically significant; the control group had an increasing trend within 1 to 24 months, However, the increase was significantly lower than that of the experimental group, and the trend of increase after 6 months was obviously reduced. PDI increased obviously after treatment in experimental group, increased fastest at 6 and 12 months and peaked at 24 months, There was an increase in March and June and a peak in December, with no significant increase in 12-24 months; however, the growth rate was significantly lower than that of the corresponding month in the experimental group. Conclusion Hyperbaric oxygen intervention is beneficial to the growth and development of children with hypoxia-ischemia. The mental development index (MDI) and motor development index (PDI) can monitor the development of children.
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