高压氧治疗前后缺氧缺血性脑病新生儿脑干听觉诱发电位变化  

Change of Brain Stem Auditory Evoked Potential in Newborn Infant with Hypoxic-Ischemic Encephalopathy after Hyperbaric Oxygen Therapy

作　　者：韩爱民[1] 王军[1] 

机构地区：[1]徐州医学院附属医院新生儿科,江苏徐州221002

出　　处：《实用儿科临床杂志》2010年第14期1055-1057,共3页Journal of Applied Clinical Pediatrics

基　　金：江苏省卫生厅医学科技发展基金(H200823)

摘　　要：目的观察HIE新生儿治疗前后脑干听觉诱发电位(BAEP)的变化,探讨高压氧(HBO)对HIE所致听力损伤的治疗作用。方法 HBO治疗组:HIE患儿106例。其中轻度HIE 82例,中重度HIE 24例。在常规治疗的基础上进行HBO治疗。对照组:HIE新生儿42例,其中轻度HIE 38例,中重度HIE 4例。采用常规治疗。在治疗前和出生第3-7天测试BAEP,出生第42天复查BAEP。比较2组BAEP异常率的变化。结果 1.对照组:轻度HIE患儿治疗前BAEP异常率为47.4%,治疗后为31.6%,二者比较差异无统计学意义(P=0.240)。中重度HIE患儿治疗前后BAEP异常率分别为75.0%和50.0%,二者比较差异无统计学意义(P=0.462)。2.HBO治疗组:轻度HIE患儿治疗前后BAEP异常率分别为45.1%和25.6%,二者比较差异有统计学意义(P=0.014)。中重度HIE患儿治疗前后BAEP异常率分别为75.0%和41.7%,二者比较差异有统计学意义(P=0.039)。3.BAEP异常者HBO治疗组和对照组治疗前后比较:2组轻度HIE患儿中BAEP异常者治疗效果比较差异有统计学意义(P=0.013);2组中重度HIE患儿中BAEP异常者治疗效果比较差异无统计学意义(P=0.717)。结论在常规治疗基础上结合HBO治疗可显著改善患儿BAEP异常率,尤其对于轻度HIE患儿,早期HBO干预治疗可显著改善其预后,减轻听力损伤,提高患儿生存质量。Objective To investigate the therapeutic role of hyperbaric oxygen（HBO） on neonatal hearing impairment induced by hypoxic - ischemie encephalopathy（HIE） ,by observing the brain stem auditory evoked potential（BAEP） changes of newborn infants with HIE. Methods One hundred and six cases of HIE in newborn infants（ in which 82 cases were mild and 24 cases were severe） treated with HBO and conventional therapy were chosen as HBO treatment group,while other 42 cases of HIE in newborn infants（ in which 38 cases were mild and 4 cases were severe） treated with conventional therapy only were served as control group. BAEP was measured at the 3^rd to 7th day on patients before treatment and 42 days after birth with or without HBO therapy respectively,and the differences of BAEP changes were compared between the both groups. Results 1. In control group,the rate of abnormality was 47.4% and 31.6% ,respectively before and after therapy in mild HIE cases（ P = 0. 240） , and 75.0% ,50.0% in the moderate- severe HIE cases（P = 0. 462）. 2. In HBO group, the abnormal rate was 45.1% and 25.6%,respectively in mild HIE cases before and after therapy,while 75.0% and 41.7% in moderate -severe HIE cases （P = 0. 014,0. 039 ）. 3. There was obvious difference between control group and HBO group in mild HIE cases （P = 0. 013 ） ,while there was no significant change between the 2 groups in moderate - severe HIE cases（ P = 0.717 ）. Conclusions Treatment with HBO combined with conventional therapy may improve the abnormal rate of BAEP in patients with HIE according to the present test,especially in mild HIE eases, thus earlier HBO therapy may be used to mitigate hearing impairment and improve prognosis induced by the disease.

关 键 词：高压氧 缺氧缺血性脑病 脑干听觉诱发电位 婴儿 新生 

分 类 号：R473.72[医药卫生—护理学]