| Objectives Meta analysis method is applied to evaluate of early interventions effects on the prognosis of neonatal hypoxic ischemic encephalopathy in our country,searchi-ng for neonatal hypoxic ischemic encephalopathy with systematic,early and continuing intervention measures and model in our country, providing for the prognosis of neonat-al hypoxic ischemic encephalopathy treatment and care clinical basis.Methods According to the literatures’retrieval strategy,a comprehensive iterature rese-arch was perfonned by computer in foreign database including PubMed,ScienceDirect database and Chinese Journals Full-text Database (CNKI), Wanfang database and V-IP Chinese science and technology periodical database, which retrieval time is scheduled for database from the start to the end of December 2015.Using NoteExpressS.1.0 soft-ware carries on the literature of check processing. At the same time with the manual ret-rieval of "Chinese Journal of nursing", "Chinese Journal of practical nursing",core jou-rnals and literature retrospective method.According to inclusion and exclusion standar-ds selected in line with the conditions of the study,extracted related research data and assessed the quality of the included randomized controlled trials. Appling Revman5.2 software on the entry of the early interventions data meta-analysis was perfonned and show merge results by forest plots. Strict quality control for each stage of the subject s-tudy.Results (1) A total of 4547 related literatures were retrieved and 19 eligible articles were included in this study, and a total of 1296 cases of children.In the inclusion study,18.5% RCTs described the random sequence generation,12.3% reported blinding of the participants and personnel,38.5% took blinding of outcome assessment,96.2% reported incomplete outcome date,43.1% had no selective reporting bias and 36.9% had no other sources of bias.(2)In the aspect of improving neonatal HIE mental development index (MDI),early interventions in 6 months [SMD=0.83,95% CI (0.41, 1.26), P=0.0001],12 months [SMD=0.94,95% CI (0.55,1.33), P<0.00001],18 months [SMD=0.79,95% CI (0.31,1.27), P=0.001], and 24 months [SMD=0.85,95% CI (0.65, 1.05), P<0.00001], the effect is superior to the routine nursing care, but in3 months, [SMD=0.81,95% CI (0.08,1.69), P=0.07],there was no statistically significant difference between two methods; (3)In the aspect of improving neonatal HIE psychomotor development index (PDI),early interventions group in 3months[SMD=0.99,95% CI (0.11,1.86), P=0.03], and 6 months [SMD=0.89,95% CI (0.40,1.37), P=0.0003],12 months [SMD=0.87,95% CI (0.69,1.05), P<0.00001],18 months [SMD=0.83,95% CI (0.60,1.06), P<0.00001], and 24 months [SMD=0.75, 95% CI (0.55,0.95), P<0.00001],the effect is better than the control group;(4)The neonatal HIE developmental quotient (DQ) meta analysis showed that in the 3 months [SMD=0.41,95% CI (0.20,0.62), P=0.0001], and 6 months [SMD=0.61,95% CI (0.42, 0.79), P<0.00001],12 months [SMD=0.85,95% CI (0.67,1.03), P<0.00001],18 months [SMD=0.94,95% CI (0.72,1.16), P<0.00001], and 24 months [SMD=1.14, 95% CI (0.70,1.59), P<0.00001], the DQ of neonatal HIE differences statistically significant;(5)In reducing the incidence rate of neonatal HIE sequelae,there is a significant difference between early, intervention and control group[OR=0.32,95% CI (0.23,0.43), P<0.00001)].Conclusion Meta analysis results show that:(1) In the aspect of improving mental dev-elopment index, in addition to the interventions for 3 months, continuous interventions 6 months and 12 months,18 months and 24 months, there is a significant difference between early interventions group and control group.And 6 months,12 months,18 months into the study of heterogeneity is larger, the result also needs careful consideration. (2) In terms of improving psychomotor development index, continuously for 3 months,6 months,12 months,18 months and 24 months, with a significant difference between early interventions group and control group.For 3 months and 6 months between different research heterogeneity is larger, the result also needs careful consideration. (3)In promoting development business, continuously for 3 months,6 months,12 months,18 months and 24 months, with a significant difference between early interventions group and control group.But while the early interventions for 24 months, heterogeneity is bigger.(4)Early interventions to reduce the incidence of neonatal HIE sequela plays a very significant statistical significance.The above results can be preliminarily concluded that:(1) The duration of the early interventions, the longer the better,can contribute to the intellectual development of neonatal HIE and reduce the incidence of sequelae.(2) Early interventions needs coordination and communication of medical staff and parents,especially parents played a significant role in early interventions,The long-term prognosis of the participation of parents to children has a positive impact, and thus improve the patient’s life quality better.Family-centered early interventions model should be widely promoted. |
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