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目的探讨早期综合干预对改善HIE患儿预后的效果,以及通过早期综合干预可达正常的患儿所具备的条件,从而早期预测神经系统后遗症,最大限度地改善患儿的预后。方法将96例中、重度HIE患儿随机分为干预组及对照组。干预组予以早期干预为主,辅以医学干预、营养干预及康复治疗的早期综合干预;对照组出院后常规育儿。3、6、12、24个月均进行智测。结果6、12、24个月时干预组平均发育商比对照组分别高12.4分、15.1分、27.0分,t值分别为3.89、4.75、8.89,差异有显著性,干预组随着干预时间延长,发育商越高。新生儿神经行为测定(NBNA)评分30～34分的患儿,经综合干预2年发育商均可达正常,而≤29分的患儿,CT和临床多呈重度改变,且伴有脑瘫,经2年干预未达正常。干预组发育商达正常(DQ>90)者为84.0%,对照组为34.8%,其中中度干预组患儿100.0%达正常,对照组40.0%达正常,差异极显著。结论早期综合干预能有效地促进HIE患儿的智能发育,7～14dNBNA评分30～34分的患儿干预效果良好;7～14dNBNA评分≤29分、CT和临床呈重度改变的患儿将发生神经系统后遗症,干预效果较差。
Objective To explore the effect of early comprehensive intervention on improving the prognosis of children with HIE and the conditions of children with normal comprehensive early intervention so as to predict the neurological sequelae and improve the prognosis to the maximum extent. Methods 96 cases of moderate and severe HIE children were randomly divided into intervention group and control group. Intervention group to be mainly early intervention, supplemented by medical interventions, nutritional intervention and rehabilitation early comprehensive intervention; control group after discharge regular child care. 3,6,12,24 months were measured. Results At 6, 12 and 24 months, the average developmental quotient of the intervention group was 12.4 points, 15.1 points and 27.0 points higher than the control group respectively, the t values were 3.89, 4.75 and 8.89, respectively. The difference was significant. In the intervention group, , The higher the developer. Neonates with neurological behavioral assessment (NBNA) score of 30 to 34 points, the comprehensive intervention of 2-year development of children were up to normal, and ≤ 29 points of children, CT and clinical were mostly severe changes, and accompanied by cerebral palsy, After 2 years of intervention did not reach normal. In the intervention group, 84.0% of the patients with normal development (DQ> 90) and 34.8% of the control group, of whom 100.0% were normal in the intervention group and 40.0% in the control group, with a significant difference. Conclusion The early comprehensive intervention can effectively promote the intelligent development of children with HIE. The children with NAB scores of 30 to 34 in 7 ~ 14 days have a good effect of intervention. The NNA scores of 7 ~ 14 days are less than or equal to 29 points in children with CT and severe clinical changes System sequelae, the intervention effect is poor.