高压氧联合神经节苷酯治疗重度新生儿缺氧缺血性脑病远期疗效观察

摘要

Objective To evaluate the long-term effect of ganglioside plus hyperbaric oxygen in the treat-ment of newborns with severe hypoxic-ischemic encephalopathy (HIE). Methods One hundred and six newborns with severe HIE were divided randomly into two groups:the control group (53 cases) and the treatment group (53 cas-es, treated with ganglioside plus hyperbaric oxygen based on the control group). At the end of 2 years old and 6 years old, the intellectual development and physical development of the children were assessed. Result Among the 106 children, 98 children were followed up finally (52 in the treatment group and 46 in the control group), while 8 were lost in the follow-up. At the end of 2 years old, for intellectual development scale of Child Development Center of Chi-na (CDCC), the mental developmental index (MDI) and psycho-motor developmental index (PDI) of the treatment group were significantly higher than those in the control group. And the end of 6 years old, verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ) of the treatment group were significantly higher. There was no sig-nificant difference on physical development (height and weight) between the two groups. Conclusion Gganglioside plus hyperbaric oxygen has a positive effect on the intellectual development of children with severe hypoxic-ischemic encephalopathy, which improves the life quality of children.%目的：观察高压氧联合神经节苷酯治疗重度新生儿缺氧缺血性脑病(HIE)的远期疗效。方法选取2004年1月至2008年12月在我院住院诊断明确的106例重度HIE患儿为研究对象，将其随机分为对照组和观察组各53例，观察组在对照组常规药物治疗基础上加用高压氧联合神经节苷酯治疗，比较两组患儿2岁和6岁时的智能发育及体格发育情况。结果106例患儿排除失访者8例，最终获得随访者对照组46例，观察组52例。2岁龄婴幼儿智能发育量表(CDCC)智能测定显示，治疗组的智力发育商数(MDI)及运动发育商数(PD)均明显高于对照组，其差异均具有统计学意义(P<0.05)；且6岁龄智能测定也同样显示治疗组患儿语言智商(VIQ)及操作智商(PIQ)明显优于对照组，差异均具有统计学意义(P<0.05)；而两组患儿同阶段的身高和体重比较差异均无统计学意义(P>0.05)。结论高压氧联合神经节苷酯治疗对重度HIE患儿远期智能发育有一定促进作用，可改善患儿长期生存质量。