早期智力干预联合神经节苷脂治疗新生儿缺氧缺血性脑病的效果(1)
[摘要]目的 探讨早期智力干预联合神经节苷脂治疗新生儿缺氧缺血性脑病的效果。方法 选取2015年5月～2016年10月我院收治的120例新生儿缺氧缺血性脑病患儿，采用随机数字表法将其分为对照组和观察组，各60例。对照组行神经节苷脂治疗，观察组在神经节苷脂治疗的基础上联合早期智力干预，比较两组患者的治疗效果。结果 观察组治疗的总有效率为96.7%，与对照组的85.0%比较，差异有统计学意义(P<0.05)；观察组满意度为98.3%，与对照组的86.7%比较，差异有统计学意义(P<0.05)；观察组患者DQ评分及神经行为评分均优于对照组，差异有统计学意义(P<0.05)。结论 采用早期智力干预联合神经节苷脂治疗新生儿缺氧缺血性脑病，能够较好地促进患儿神经系统的发育，改善患儿感知认知水平，进而改善患儿预后，应用价值较高。
[关键词]早期治疗干预；神经节苷脂；新生儿缺氧缺血性脑病
[中图分类号] R722.1 [文献标识码] A [文章编号] 1674-4721(2017)05(c)-0046-03
[Abstract]Objective To investigate the effect of early intelligence intervention combined with ganglioside in the treatment of neonatal hypoxic ischemic encephalopathy (HIE).Methods 120 cases of neonatal hypoxic ischemic encephalopathy (HIE) in our hospital from May 2015 to October 2016 were selected and randomly divided into two groups：control group and observation group，60 in each group.The control group was treated with ganglioside treatment，while the observation group was given early intelligence intervention on the basis of ganglioside treatment，and the final treatment effect of the two groups were compared.Results The total effective rate of the observation group was 96.7%，compared with 85.0% in the control group，with significant difference (P<0.05)；satisfaction of the observation group was 98.3%，compared with 86.7% in the control group，with significant difference (P<0.05)；the DQ score and neurological score of the patients in the observation group were better than the control group，the differences were statistically significant (P<0.05).Conclusion The early intelligence intervention combined with ganglioside treatment of neonatal hypoxic-ischemic encephalopathy can promote the development of the nervous system of children，improve children′s perception of cognitive level，and improve the prognosis，with higher application value.
[Key words]Early therapeutic intervention；Ganglioside；Neonatal hypoxic-ischemic encephalopathy
新生兒缺氧缺血性脑病属于临床常见病，危害性较大，若不及时进行治疗，将会造成患儿伤残，严重时可能造成永久神经功能障碍，给家庭和社会都带来了沉重负担[1-2]。临床在对新生儿缺氧缺血性脑病患儿进行治疗时，常应用神经节苷脂来改善预后、减少神经系统后遗症出现，但是单用效果并不理想[3]，采用综合性治疗措施可提高患儿的预后。本研究以120例新生儿缺氧缺血性脑病患儿为研究对象，探讨了神经节苷脂联合早期智力干预的效果，现作如下报道。
1资料与方法
1.1一般资料
随机选取我院2015年5月～2016年10月收治的120例新生儿缺氧缺血性脑病患儿，采用随机数字表法将其分为对照组和观察组，各60例。对照组男38例，女22例；中度36例，重度24例；胎龄38～41周，平均(39.5±1.0)周。观察组男39例，女21例；中度35例，重度25例；胎龄37～40周，平均(38.5±1.0)周。两组患儿基础资料比较，差异无统计学意义(P>0.05)，具有可比性。
1.2方法
两组均给予对症治疗，维持换气功能的通畅，控制好心率、血压水平。若患儿病情稳定，未出现呼吸困难等症状，同时行头颅MRI或CT明确诊断后(频繁抽搐及颅内出血者待病情平稳后)，对照组给予神经节苷脂钠20 mg加入10%葡萄糖注射液20～40 ml中静脉滴注，1次/d，10 d为1个疗程，每个疗程间休息10 d，共用3～5个疗程。观察组在神经节苷脂治疗的基础上联合早期智力干预，具体如下，①视觉刺激：当患儿处于安静状态时，于患儿眼前晃动颜色鲜艳的物体，让患儿能注视物体，15 min/次，5次/d。当患儿被物体吸引后，采取视觉跟踪训练。②声觉刺激：播放歌曲，讲故事，对患儿的声觉进行刺激。③触觉刺激：抚触患儿四肢、头、胸、腹及四肢，15 min/次，2次/d。④四肢活动训练：采用婴儿被动体操，刺激患儿的活动，15 min/次，2次/d。院内的早期智力干预由家长协助护理人员共同完成，院外则由家长对患儿进行声光刺激训练。 (李光忠)
[关键词]早期治疗干预；神经节苷脂；新生儿缺氧缺血性脑病
[中图分类号] R722.1 [文献标识码] A [文章编号] 1674-4721(2017)05(c)-0046-03
[Abstract]Objective To investigate the effect of early intelligence intervention combined with ganglioside in the treatment of neonatal hypoxic ischemic encephalopathy (HIE).Methods 120 cases of neonatal hypoxic ischemic encephalopathy (HIE) in our hospital from May 2015 to October 2016 were selected and randomly divided into two groups：control group and observation group，60 in each group.The control group was treated with ganglioside treatment，while the observation group was given early intelligence intervention on the basis of ganglioside treatment，and the final treatment effect of the two groups were compared.Results The total effective rate of the observation group was 96.7%，compared with 85.0% in the control group，with significant difference (P<0.05)；satisfaction of the observation group was 98.3%，compared with 86.7% in the control group，with significant difference (P<0.05)；the DQ score and neurological score of the patients in the observation group were better than the control group，the differences were statistically significant (P<0.05).Conclusion The early intelligence intervention combined with ganglioside treatment of neonatal hypoxic-ischemic encephalopathy can promote the development of the nervous system of children，improve children′s perception of cognitive level，and improve the prognosis，with higher application value.
[Key words]Early therapeutic intervention；Ganglioside；Neonatal hypoxic-ischemic encephalopathy
新生兒缺氧缺血性脑病属于临床常见病，危害性较大，若不及时进行治疗，将会造成患儿伤残，严重时可能造成永久神经功能障碍，给家庭和社会都带来了沉重负担[1-2]。临床在对新生儿缺氧缺血性脑病患儿进行治疗时，常应用神经节苷脂来改善预后、减少神经系统后遗症出现，但是单用效果并不理想[3]，采用综合性治疗措施可提高患儿的预后。本研究以120例新生儿缺氧缺血性脑病患儿为研究对象，探讨了神经节苷脂联合早期智力干预的效果，现作如下报道。
1资料与方法
1.1一般资料
随机选取我院2015年5月～2016年10月收治的120例新生儿缺氧缺血性脑病患儿，采用随机数字表法将其分为对照组和观察组，各60例。对照组男38例，女22例；中度36例，重度24例；胎龄38～41周，平均(39.5±1.0)周。观察组男39例，女21例；中度35例，重度25例；胎龄37～40周，平均(38.5±1.0)周。两组患儿基础资料比较，差异无统计学意义(P>0.05)，具有可比性。
1.2方法
两组均给予对症治疗，维持换气功能的通畅，控制好心率、血压水平。若患儿病情稳定，未出现呼吸困难等症状，同时行头颅MRI或CT明确诊断后(频繁抽搐及颅内出血者待病情平稳后)，对照组给予神经节苷脂钠20 mg加入10%葡萄糖注射液20～40 ml中静脉滴注，1次/d，10 d为1个疗程，每个疗程间休息10 d，共用3～5个疗程。观察组在神经节苷脂治疗的基础上联合早期智力干预，具体如下，①视觉刺激：当患儿处于安静状态时，于患儿眼前晃动颜色鲜艳的物体，让患儿能注视物体，15 min/次，5次/d。当患儿被物体吸引后，采取视觉跟踪训练。②声觉刺激：播放歌曲，讲故事，对患儿的声觉进行刺激。③触觉刺激：抚触患儿四肢、头、胸、腹及四肢，15 min/次，2次/d。④四肢活动训练：采用婴儿被动体操，刺激患儿的活动，15 min/次，2次/d。院内的早期智力干预由家长协助护理人员共同完成，院外则由家长对患儿进行声光刺激训练。 (李光忠)