The Effects Of Early Behavioral Intervention And Hyperbaric Oxygen On The Neonates With Hypoxic Ischemic Encephalopathy

ObjectTo study the effects of early intervention and hyperbaric oxyge(nHBO)on neonates with hypoxic-ischemic encephalopathy (HIE),and to find out precautions for the brain lesion caused by perinatal asphyxiation.Methods88 cases of neonates with moderate HIE were randomly divided into the intervention group A (n=30), the intervention group B (n=28)and the controlled groups (n=30).There was no significantly differences in general conditions among three groups.In the group A and B,the neonates received early intervention on thigmesthesia,vision, auditory and vestibular for 3 months.when patients were stayed in hospital,the neonates received behavioral intervention by the staffs.When patients got out of hospital,they were trained by their parents who had learned how to train their infants .Group A received HBO therapy in addition to those early intervention as group B.The rate of ascending-descending Pressure was 0.002-0.0025MPa/min,The pressure of that was 0.04-0.05Mpa.The compression time was twenty minutes,The stabie time was thirty minutes,The descending pressure time was twenty time.The inspired oxgen time on stable pressure was thirty minutes,seven times a treatment course,one treatment course month,There were there treatment Courses.The therapeutic evaluation were done as below. The patient were tested when 14d,28d and pre-cure with Neonatal Behavioral Neurological Assessment ( NBNA ) .The mental development index(MDI) and psychomotor development test(PDI) were evaluated with CDCC when the infant's age were at 3 months and 6 months. The intelligence development test of them were administered with Gesell development diagnosis scale when they were 1 year old. ResultsThe scores in NBNA were no differents between the infants at 14d and 28d after birth in the group A(36.3 ) and the group B (35.54) (P>0.05),but were significantly better than those of the controlled group (P <0.01).The scores of MDI and PDI in group A were higher than group B when they were 3 and 6 months old(P <0.01).But the scores of MDI and PDI in controlled group were lower than the group A and the group B .There were no differents in DQ between group A and B (P>0.05),but DQ in these two groups were higher than the controlled group (P <0.01) when they were 1 year old.The incidence rate of commemorative signs in both of the group A and B were lower than that of the controlled group.ConclusionsEarly intervention can promote the CNS development of neonates,and improve the prognosis of HIE.The therapy of early intervention combinded HBO can elevated the intelligence development index of the infants at 3 and 6 months old,but the long-term effects will be further follow-up on mental development of children with HIE.