早期抚触联合高压氧或水疗对重度新生儿缺氧缺血性脑病近期神经运动功能的影响

【目的】探讨早期抚触联合高压氧疗、水疗对重度新生儿缺氧缺血性脑病（HIE）近期神经运动功能的影响。【方法】收集 H IE患儿497例，按照治疗方法分为A、B、C三组，A组采用单纯早期抚触，B组抚触联合高压氧疗，C组采用抚触联合水疗。对比三组患儿运动功能、神经20项评分标准（NBNA）评分及治疗后体质量、身高、每日摄奶量情况。【结果】治疗后A组完成Ⅲ级动作比例明显低于B组和C组（P＜0．05），其中B组与C组相比差异无统计学意义（ P＞0．05）；治疗2周、4周后B组、C组NBNA评分显著高于A组（ P＜0．05），其中B、C两组间相比NBNA评分差异无统计学意义（P＞0．05）；治疗4周后B组、C组患儿体质量、身高、每日摄奶量均显著优于A组（P ＜0．05），B、C组两两相比差异无统计学意义（P ＞0．05）。【结论】早期抚触联合高压氧或水疗均可以促进HIE患儿神经运动功能的康复，有利于新生儿的生长、发育，值得临床推广应用。

Observation on the Effect of Early Massage Combined with Hyperbaric Oxygen or Hydrotherapy on Recent Nerve Motor Function of Severe Neonatal HIE

Objective]To explore the effect of early massage combined hyperbaric oxygen therapy ,hydrotherapy on recent nerve motor function of severe neonatal hypoxic-ischemic encephalopathy（HIE） .Methods]Totally 497 patients with HIE were collected .According to the treatment methods ,all patients were divided into group A ,B and C .Group A received simple early massage ,and group B received massage combined with hyperbaric oxygen therapy ,and group C received massage combined with hydrotherapy .Motor function ,nerve 20-item score criteria（NBNA） score ,body weight ,height ,daily milk intake after treatment were compared a-mong 3 groups .Results]After treatment ,the proportion of taking grade Ⅲ action in group A was obviously lower than that in group B and group C（ P 〈0 .05） ,but there was no significant difference between group B and group C（ P〉0 .05） .NBNA scores in group B and group C at 2 and 4 weeks after treatment were signifi-cantly higher than those in group A （ P 〈0 .05） ,but there was no significant difference in NBNA score between group B and group C（ P〉0 .05） .The weight ,height and daily milk intake in group B and group C at 4 weeks after treatment were significantly better than group A （ P 〈0 .05） ,but there was no significant difference between group B and group C（ P〉0 .05） .Conclusion]Early massage combined with hyperbaric oxygen or hydrotherapy can promote neural motor function rehabilitation in pediatric patients with HIE and is conducive to neonatal growth and development .Therefore ,it is worthy of clinical promotion .