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目的:探讨新生儿行为神经测定(NBNA)对足月新生儿缺氧缺血性脑病(HIE)预后预测的价值。方法:对114例足月新生儿HIE患儿于生后7d、14d、28d行NBNA评分,并临床随访跟踪,3个月、6个月、12个月、18个月时行智能发育测定。结果:中、重度缺氧缺血性脑病患者不同时期的NBNA评分异常(≤35分)率明显高于轻度缺氧缺血性患者,3次NBNA评分均≤35分的共有19例,其中轻度HIE者为零、中度HIE者有6人(发生率为31.58%)、重度HIE者占13人(发生率为68.42%),智能发育随访中NBNA评分>35分者智能发育指数(MDI)均>90分,3次NBNA评分≤35分的19人中MDI<70分3个月时发生率为84.2%,6个月、12个月、18个月时发生率均为89.47%。NBNA评分可预测缺氧缺血性脑病的预后。结论:NBNA评分是一种客观、无创、经济、简便有效的临床评估新生儿缺氧缺血性脑病预后的方法,为早期干预减少伤残提供依据。
Objective: To investigate the value of neonatal behavioral nerve assay (NBNA) in predicting the prognosis of full-term neonatal hypoxic-ischemic encephalopathy (HIE). Methods: The NBNA scores of 114 full-term neonates with HIE were measured at 7d, 14d and 28d after birth. The patients were followed-up for clinical follow-up for 3 months, 6 months, 12 months and 18 months. Results: The rates of abnormal NBNA score (≤35 points) in patients with moderate and severe hypoxic-ischemic encephalopathy were significantly higher than those in mild hypoxic-ischemic patients, and there were 19 cases with three NBNA scores ≤35 points Mild HIE was zero, moderate HIE in 6 (31.58% incidence), severe HIE accounted for 13 (incidence of 68.42%), intelligent development follow-up NBNA score> 35 points in the index of development of intelligence ( MDI) were all higher than 90 points. The incidence of MDI <70 at 3 months was 84.2% in 19 out of 19 people with 3 NBNA scores <35 points. The incidence rates at 6, 12 and 18 months were 89.47% . The NBNA score predicts the prognosis of hypoxic-ischemic encephalopathy. Conclusion: The NBNA score is an objective, noninvasive, economical and simple clinical effective method to evaluate the prognosis of neonatal hypoxic-ischemic encephalopathy and provide basis for early intervention to reduce disability.