高压氧治疗新生儿缺氧缺血性脑病疗效观察

目的　为评价高压氧 (HBO)对新生儿缺氧缺血性脑病 (HIE)的确切疗效 ,尤其是远期效果。方法　 140例 HIE患儿随机分为 HBO治疗组 78例 (简称治疗组 )和对照组 6 2例。两组均给予相同的综合治疗 ,治疗组加用 HBO治疗。存活病例随访至 1～ 4岁。采用国内 CDCC量表测定智商。同时进行体格发育和神经系统、视力及听力检查。结果　中、重度患儿 ,治疗组神经系统症状消失平均天数短于对照组 3d以上 (t=5 .78,P<0 .0 1)。治疗组随访 72例 ,康复 6 3例 ,后遗症 8例 ,死亡 1例。对照组随访 5 5例 ,康复 42例 ,后遗症 10例 ,死亡 3例。两组轻度患儿均无死亡及后遗症。结论　 HBO可缩短中、重度 HIE患儿疗程 ;早期治疗可提高治愈率 ,减少后遗症 ;晚期治疗 ,近期疗效明显 ,但重症不能改善预后。

Effect of hyperbaric oxygenation in treatment of neonatal hypoxic ischemic encephalopathy

Objective To study the efficacy of hyperbaric oxygenation (HBO) in curing the newborn with HIE.Methods One hundred and forty cases of neonates with HIE (hypoxic-ischemic encephalopathy) were divided randomly into HBO group (n=78) and control group (n=62).The survival cases were followed up for 1～4 years.The IQ was estimated by using mental development indexes (MDI).Physical and mental development,vision and hearing were also examined.Other concurrent therapies were the same in the two groups.Results ①The nervous system recovery time in moderate and severe cases were (5.4±2.2)days in HBO group and (8.6±3.5)days in control group (t=5.78,P<0.01).Those mild cases showed no differences between the two groups.②HBO group had 8 sequela cases and one dead case,but control group had 10 sequela and 3 dead.③The early treatment of HIE gave an unfavorable prognosis rate only 7.8% in HBO group,but gave 23.6% in control group (χ 2=3.9,P<0.05).The late treatment gave no differences between the two groups.Conclusion HBO has a fairly shorter course in treating the moderate～severe HIE;its early use can improve the cure rate,reduce sequela;its late use also gives an immediate effect,but severe cases would not expect a favorable prognosis.