重度新生儿缺氧缺血性脑病的治疗和早期干预依从性与远期预后的影响关系

目的:探讨重度新生儿缺氧缺血性脑病的治疗和早期干预依从性与远期预后的影响。方法:将2007年8月～2012年8月入住我院的120例重度新生儿缺氧缺血性脑病患者随机地分为对照组与观察组,对照组(n=64)为出生后24～72h参与就诊的患儿,观察组(n=56)为出生～24h参与就诊的患儿,根据就诊的时间,又可以将其分为如下3个亚组:Ⅰ组(出生～6h)14人,Ⅱ组(出生6～12h)26人,Ⅲ组(出生12～24h)16人。每组患儿均于入住医院之后给予相同的干预治疗,全部患儿均于3、6月龄来我院儿童保健科进行复查一次。采用中国标准化的贝来量表(CDCC)分别测定两组患儿早期干预后智力发育指数(MDI)、运动发育指数(PDI),且对比两组干预治疗后各能区智能发育商得分及脑瘫发生率。结果:(1)3月与6月时,仅Ⅰ组MDI值要明显大于对照组(P<0.01),Ⅱ组、Ⅲ组MDI值与对照组差异无统计学意义(P>0.05);Ⅰ组与Ⅱ组比较,3月与6月时MDI值的差异具有统计学意义(P<0.05),且Ⅰ组与Ⅲ组比较,差异具有显著的统计学意义(P<0.01),但Ⅱ组与Ⅲ组比较,差异无统计学意义。(2)PDI得分结果同(1)。(3)两组干预治疗后各能区智能发育商得分差异具有显著的统计学意义(P<0.01)。(4)观察组脑瘫发病率为5.36%,远低于对照组(18.75%),二者差异具有显著的统计学意义(P<0.01)。结论:早期干预的效果在一定程度上受到治疗时间的影响,即越早治疗,对患儿的远期预后越有利。

Severe neonatal hypoxic ischemic encephalopathy treatment and early intervention compliance and long-term prognosis

Objective: To discuss the treatment of severe neonatal hypoxic-ischemic encephalopathy,the relationship of early intervention compliance and long-term prognosis.Methods: A total of 120 cases of severe neonatal hypoxic-ischemic encephalopathy patients that were admitted to our hospital during 2007.08-2012.08 were randomly divided into control group and an observation group.The control group(n=64) were infants that admitted 24-72h after birth and the observation group(n=56) were infants admitted within 24h of birth.Specifically,the observation group was divided into 3 subgroups including group 1(admitted within 6 after birth,n=14),group 2(admitted 6-12 hours after birth,n=26),and group 3(admitted 12-24 hours after birth,n=16).All groups were given the same intervention,and at the age of 3 months and 6 months,all these infants were evaluated with Standardized beta in China Scale(CDCC) to detect and compare the mental development index(MDI) and psychomotor development index(PDI).Results:(1) At the age of 3 months and 6 months,only group 1 showed significant higher MDI value than the control group(P<0.01);significant difference in MDI were also observed between group 1 and group 2(P<0.05)/group 1 and group 3(P<0.01).(2) Similar results for PDI as MDI.(3) After intervention,significant difference in various energies smart developmental quotient score difference was observed(P<0.01).(4) Incidence of cerebral palsy was 5.36% in observation group,much lower than 18.75% of the control group(P<0.01).Conclusion: The effect of early intervention is correlated with admission time,earlier treatment benefits long-term prognosis.