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目的:探讨中度缺氧缺血性脑病患儿的早期治疗的最佳时间。方法:搜集1998～2008年期间收治的中度缺氧缺血性脑病(HIE)患儿608例,诊断采用1996年杭州会议的诊断标准。结果:轻度155例,中度388例,重度65例,治疗前均有不同程度的神经系统异常表现。治疗后至婴儿6个月时再进行评价,155例轻度患者没有遗留神经系统不良症状,中度患者388例遗留神经系统不良症状7例,重度患者64例遗留神经系统不良症状(100%)。中度患者388例中的283例是在出生后3天内得到治疗,遗留神经系统不良症状2例,另外的105例是在出生后3天后得到治疗,遗留神经系统不良症状5例,后遗症的发生率为1%。中度患者3天前后得到治疗的效果,据统计学处理P<0.01,差异有统计学意义。结论:早发现、早治疗,尤其是3天内得到治疗可以最大限度地减少中度患者神经系统不良症状的发生。
Objective: To investigate the best time for early treatment of children with moderate hypoxic ischemic encephalopathy. Methods: A total of 608 children with moderate hypoxic-ischemic encephalopathy (HIE) were collected from 1998 to 2008. The diagnosis was based on the diagnostic criteria of the 1996 Hangzhou conference. Results: There were 155 mild cases, 388 moderate cases and 65 severe cases. Before treatment, all patients had different degrees of neurological abnormalities. There were no adverse neurological symptoms in 155 mild cases, 388 cases of residual neurological symptoms in moderate cases, 7 cases of residual neurological deficits in severe cases, and 64 cases of severe neurological deficits (100%) in severe cases. . Of the 388 moderate-to-388 patients, 283 were treated within 3 days of birth, 2 were left with adverse neurological symptoms, another 105 were treated 3 days after birth, 5 were left with adverse neurological symptoms, and sequelae occurred The rate is 1%. Moderate patients were treated 3 days before and after the results, according to the statistical treatment of P <0.01, the difference was statistically significant. CONCLUSIONS: Early detection and early treatment, and especially treatment within 3 days, can minimize the occurrence of neurological symptoms in moderate-to-severe patients.