Early intervention and prognosis of neonatal hypoxic iachemic encephalopathy

Abstract

Objective To explore the optimal timing of prevention and treatment for neonatal hypoxic ischemic encephalopathy ( HIE ) and to provide theoretical and clinical support for the treatment of HIE.Methods 125 neonates with HIE were assessed and divided into control group ( visits within 24 - 72 h after birth ) and study group ( visits within 24h after birth ).The study group was subdivided into intervention group Ⅰ ( 43 neonates,within 6 h ) and group Ⅱ ( 40 neonates,within 6 - 24 h after birth ).Each group received the same treatment.The neonates were assessed by neonatal behavioral neurological assessment ( NBNA )before treatment and 14 days after birth,and determined by DQ 6 months after birth.Results Before intervention,NBNA was ( 34.2 ± 1.64 ) in group 1,( 33.8 ± 1.43 ) in group Ⅱ,and ( 33.3 ± 1.23 ) in the control group,with no significant different among these three groups (P＞ 0.05); 14 days after treatment,it was ( 38.0 ± 1.92 )in group Ⅰ,( 36.9±1.91 ) in group Ⅱ,and ( 36.3 ± 1.88 ) in the control group,with significant difference among these three groups ( P ＜ 0.05 ); although the score was higher in group Ⅱ than in the control group,the difference was not statistically significant ( P ＞ 0.05 ); Only 100 children received DQ at a age within six months,and whose value of DQ was less than 80:3 of 31patients in group Ⅰ or 9.68％,6 of 33 in group Ⅱ or 18.18％,and 7 of 36 in the control group or 19.44％,there was a significant difference between group Ⅰ and Ⅱ group or the control group ( P ＜ 0.05 ),and there was no significant difference between group Ⅱ and the control group ( P ＞ 0.05 ).Conclusions The prognosis of hypoxic ischemic encephalopathy is significantly different with different periods of the early intervention.The NBNA on day 30 DQ at a age within 6 months in the neonates receiving treatment with 2 - 6 h and six months after birth were significandy better than those in the neonates treated 6h after birth,revealing the optimal time to treat hypoxic ischemic encephalopathy may be within 2 - 6h after brith. Key words: Early intervention; Hypoxic ischemic encephalopathy; Neonate; Optimal time