摘要
目的探讨早期高压氧联合婴儿抚触辅助干预新生儿缺血缺氧性脑病的疗效。方法选择2019年1月至2020年1月在本院干预的120例新生儿缺血缺氧性脑病患儿,按干预方法的不同分为对照组和观察组,每组60例,两组患儿均进行常规药物干预,对照组再给予高压氧干预,10 d为1个疗程,间隔10 d进入下个疗程,根据病情严重程度干预3~5个疗程,观察组给予高压氧联合婴儿抚触辅助干预,高压氧干预方法同对照组,依次对头、胸、腹肌、四肢进行抚触,每次15 min,每日2次,记录两组临床表现恢复时间,干预前及干预2个月进行新生儿行为神经测定(NBNA)评分,采用婴幼儿发育量表中的精神运动发育指数(PDI)和智力发育指数(MDI)分别评价患儿的整体运动及智力水平,在干预结束时评价两组临床疗效,所有患儿均随访2年,统计两组患儿随访结束时身高、体质量变化情况及神经系统后遗症发生率。结果观察组和对照组的意识恢复时间[(2.25±0.88)d和(4.20±1.03)d]、肌张力恢复时间[(2.88±1.14)d和(5.34±1.35)d]、反射恢复时间[(3.06±1.85)d和(5.95±1.73)d]、脑水肿消退时间[(2.58±1.25)d和(5.55±1.70)d]比较,差异有统计学意义,P<0.05。观察组治疗后NBNA、PDI、MDI评分明显高于治疗前及对照组治疗后,P<0.05。观察组临床总有效率明显高于对照组,P<0.05。观察组患儿出现1例智力低下,对照组出现智力低下4例、脑瘫1例、运动发育迟缓3例,两组神经系统后遗症发生率分别为1.67%和13.33%,差异有统计学意义,P<0.05。结论早期高压氧联合婴儿抚触辅助干预新生儿缺血缺氧性脑病的疗效确切,有助于加快患儿的意识、肌张力、反射恢复,促进脑水肿消退,有效提高临床疗效,改善患儿预后。
Objective To investigate the effect of early hyperbaric oxygen combined with infant stroking in the intervention of neonatal hypoxic ischemic encephalopathy.Methods A total of 120 cases of neonatal hypoxic ischemic encephalopathy who were intervened in our hospital from January 2019 to January 2020 were selected,and they were divided into control group and observation group according to different intervention methods,with 60 cases in each group.Drug intervention,the control group was given hyperbaric oxygen intervention,10 d as a course of treatment,and the next course of treatment was entered at 10 d intervals.According to the severity of the disease,the intervention group was given 3-5 courses of treatment.Methods The same as the control group,the head,chest,abdominal muscles,and limbs were touched in turn,15 minutes each time,twice a day,the recovery time of clinical manifestations was recorded,and the neonatal behavioral neurological assessment(NBNA)score was performed before and at the end of the intervention.The psychomotor development index(PDI)and mental development index(MDI)of the infant development scale were used to evaluate the overall motor and intelligence levels of the children,respectively.At the end of the intervention,the clinical efficacy of the two groups was evaluated.All children were followed up for 2 years.Statistics changes in height and weight and the incidence of neurological sequelae were compared between the two groups at the end of follow-up.Results The recovery of consciousness[(2.25±0.88)d and(4.20±1.03)d],recovery of muscle tension[(2.88±1.14)d and(5.34±1.35)d],recovery of reflex[(3.06±1.85)d and(5.95±1.73)d],and brain edema resolution time[(2.58±1.25)d and(5.55±1.70)d]had significant differences,P<0.05.The scores of NBNA,PDI and MDI in the observation group after treatment were significantly higher than those before treatment and those in the control group after treatment,P<0.05.The clinical total effective rate in the observation group was significantly higher than that in the control group,P<0.05.There was 1 case of mental retardation in the observation group,4 cases of mental retardation,1 case of cerebral palsy,and 3 cases of motor developmental retardation in the control group,the incidence rates of neurological sequelae in the two groups were 1.67%and 13.33%,respectively,and the difference was statistically significant,P<0.05.Conclusion Early hyperbaric oxygen combined with infant stroking has a definite curative effect on neonatal hypoxic ischemic encephalopathy,which is helpful to speed up the recovery of consciousness,muscle tone and reflex,promote the regression of cerebral edema,effectively improve the clinical efficacy,and improve the prognosis of children.
作者
林瑞凤
蔡玉伟
郑碧兰
LIN Ruifeng;CAI Yuwei;ZHENG Bilan(Department of Pediatrics,Affiliated Hospital of Putian University,Putian 351100,China)
出处
《中国医药指南》
2022年第26期82-84,88,共4页
Guide of China Medicine
关键词
新生儿
缺血缺氧性脑病
早期高压氧
婴儿抚触
Neonatal
Hypoxic ischemic encephalopathy
Early hyperbaric oxygen
Infant touch
