摘要
目的探讨新生儿缺氧缺血性脑病（HIE）最佳治疗时间窗，为HIE的治疗提供理论和临床依据。方法选取125例HIE患儿，根据开始治疗时间分为对照组（生后24～72h就诊）和观察组（生后24h内就诊）；根据干预时间将观察组分为I组43例（生后6h内）和Ⅱ组40例（生后6～24h）；每组患儿入院后，给予完全相同的干预治疗，并于干预治疗前和生后14d分别进行20项新生儿行为神经测定（NBNA），于生后6个月做儿心量表测定（DQ）。结果各组患儿干预治疗前NBNA比较：I组（43例）为（34．2±1．64）分，Ⅱ组（40例）为（33．8±1．43）分、对照组（42例）为（33．6±1．23）分，I组与Ⅱ组及对照组比较差异均无统计学意义（P〉0．05）；经治疗后d14NBNA比较：I组为（38．0±1．92）分，Ⅱ组为（36．9±1．91）分，对照组为（36．3±1．88）分，I组与Ⅱ组及I组与对照组比较差异均有统计学意义（P〈0．05），1I组分值虽较对照组高但差异无统计学意义（P〉0．05）；仅100例患儿至半岁时做DQ，DQ值〈80分：I组（31例）3例（9．68％），I／组（33例）6例（18．18％），对照组（36例）7例（19．44％），I组与对照组及Ⅱ组比较差异有统计学意义（尸〈0．05），Ⅱ组虽较对照组高但差异无统计学意义（P〉0．05）。结论早期不同时间干预治疗HIE的预后明显不同，生后2。6h开始治疗的患儿其d30NBNA和半岁DQ值明显优于是6h后开始治疗的患儿；提示HIE的最佳时间窗可能为生后2—6h。
Objective To explore the optimal timing of prevention and treatment for neonatal hypoxic ischemic encephalopathy （ HIE ） and to provide theoretical and clinical support for the treatment of HIE. Methods 125 neonates with HIE were assessed and divided into control group （ visits within 24 - 72 h after birth ） and study group （ visits within 24 h after birth ）. The study group was subdivided into intervention group I （ 43 neonates, within 6 h ） and group 1] （ 40 neonates, within 6 - 24 h after birth ）. Each group received the same treatment. The neonates were assessed by neonatal behavioral neurological assessment （ NBNA ） before treatment and 14 days after birth, and determined by DQ 6 months after birth. Results Before intervention, NBNA was （ 34.2 ±1.64 ） in group I, （ 33.8 ±1.43 ） in group II, and （ 33.3 ± 1.23 ） in the control group, with no significant different among these three groups （P〉 0.05）; 14 days after treatment, it was （ 38.0 ± 1.92 ） in group I, （ 36.9 ± 1.91 ） in group II, and （ 36.3 ±1.88 ） in the control group, with significant difference among these three groups （ P 〈 0.05 ）; although the score was higher in group II than in the control group, the difference was not statistically significant （ P 〉 0.05 ）; Only 100 children received DQ at a age within six months, and whose value of DQ was less than 80： 3 of 31 patients in group I or 9.68%, 6 of 33 in group Ⅱ or 18.18%, and 7 of 36 in the control group or 19.44%, there was a significant difference between group I and Ⅱ group or the control group （ P 〈 0.05 ）, and there was no significant difference between group Ⅱ and the control group （P 〉 0.05 ）. Conclusions The prognosis of hypoxic ischemic encephalopathy is significantly different with different periods of the early intervention. The NBNA on day 30 DQ at a age within 6 months in the neonates receiving treatment with 2 - 6 h and six months after birth were significantly better than those in the neonates treated 6h after birth, revealing the optimal time to treat hypoxic ischemic encephalopathy may be within 2 - 6h after brith.
出处
《国际医药卫生导报》
2012年第13期1871-1873,共3页
International Medicine and Health Guidance News
基金
广东深圳市福田区科学技术任务项目（FTWS075）
关键词
早期干预
缺氧缺血性脑病
新生儿
最佳时间窗
Early intervention
Hypoxic ischemic encephalopathy
Neonate
Optimal time
