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【目的】探讨早期规范治疗的轻、中度新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)患儿婴儿期神经心理发育水平,为HIE患儿的婴儿期发育评价及研究提供依据。【方法】将应用GM1规范治疗的轻、中度HIE患儿分别做为观察1组和观察2组,将与该类HIE患儿同期在本院出生的正常新生儿做为对照组,三组新生儿分别建立专科档案进行1年的随访,并均在3、6、12个月时,用Gesell婴幼儿发育量表进行测试评估。【结果】1)3个月时观察1组和观察2组的5个能区发育商(developmental quotient,DQ)均低于对照组,差异有高度统计学意义(P<0.01);2)6个月时观察1组与对照组5个能区的DQ差异无统计学意义(P>0.05);观察2组5个能区的DQ比对照组婴儿低,差异有统计学意义(P<0.05);3)12个月时观察2组的精细动作和适应行为的DQ仍比对照组的相应能区低,差异有统计学意义(P<0.05)。【结论】轻、中度HIE患儿在婴儿期可遗留智力发育及心理行为发育落后,但随着月龄的增加,智力及行为发育有个追赶过程,尤其在大运动、语言和个人社交方面追赶明显,轻度HIE患儿可达到正常儿发育水平;部分中度HIE患儿的精细运动和适应行为追赶缓慢,在今后的实践中,干预的重点是精细动作和适应行为。
【Objective】 To investigate the infant neuropsychological development in mild and moderate neonates with hypoxic-ischemic encephalopathy (HIE) during early normative treatment and to provide evidence for the evaluation and study of infant development in HIE . 【Methods】 The children with mild and moderate HIE treated with GM1 regimen were divided into observation group 1 and observation group 2, respectively. Normal neonates born in our hospital with this type of HIE were used as the control group. Three groups Newborns were established specialist files for 1 year follow-up, and were 3,6,12 months, using the Gesell Infant Development Scale test evaluation. 【Results】 1) At 3 months, the developmental quotient (DQ) of observation group 1 and observation group 2 were lower than that of the control group, the difference was statistically significant (P <0.01); 2) 6 There was no significant difference in DQ between the observation group 1 and control group in 5 months (P> 0.05), while the DQ in the 5 energy zones in 2 groups was lower than that in the control group (P <0.05) ); 3) At 12 months, the DQ of the fine motor and adaptive behavior of the two groups was still lower than that of the control group, with significant difference (P <0.05). 【Conclusion】 The children with mild and moderate HIE may be left behind with mental and behavioral development in infancy, but with the increase of age, there is a catch-up process in the development of intelligence and behavior, especially in large-scale exercise, language and social interaction Catch-up obviously, mild HIE children can reach normal children’s level of development; some moderate HIE children fine motor and adaptive behavior to catch up slowly, in the future practice, the focus of intervention is the fine movement and adaptation behavior.