| Objective Hypoxia ischemic encephalopathy not only accounts for high perinatal mortality,moreover can cause morbidity of cognitive impairment and development retardation after neonates.Although traditional therapy is in good practice in the early time after delivery,further treatments for HIE can hardly be carried on because of being lack of enough money and partnership from patients' guardians in China.We are to investigate the affect of further therapy which consist of drug and Non-drug treatments on HIE neonates in this study for the discussion improves the HIE prognosis the method.Methods Neonates with medium and severe HIE who admitted to newborn nursery were enrolled in this study.They were divided into control group C and treated group A and B after early neonatal therapy,depending on the agreement and the economic station of patients' guardians.Multiple traditional treatments were done for all 3 groups, according to HIE treatment plan.Supporting treatments for respiratory,circulation and metabolism systems with intervention therapies for seizure,brain cell edema, respiratory rhythem inhibition caused by brainstem have been done in first 3 days after delivery.While in the fourth day,Cerebroprotein Hydrolysate-Livzon Libao(5ml/d) added in 30ml liquid and Danshen Root 1.5ml/kg.d in 30ml liquid were taken as intraveneous fluids also.It lasts about 10～14 days for newborn with medium HIE,and 3～4 weeks for severe HIE neonates.All patients were monitored with the 20 NBNA tests at the 5th～7th,14th,28th day after delivery.Early interventions were taken for neonates in group A and B including hearing and seeing,sensation,memory,and movement training,persisted makes the massage to hold,The different age of the moon baby holds and so on.Patients in group A received intravenous drug lizhusaile with 5ml/d for 10days,3 treatment courses.The convention nurtures does not carry on the medicine intervention in group C.Following investigation about all nonates in 3 groups are continual in the clinical early education,and in the 1st,6th,12th month,and 3rd year, Mntal development are evaluated in CDCC,scored in mental development index(MDI) and physical development index(PDI),and these statistic datas among all patients in the 12th month,3rd year will be analysised.Results 20 NBNA score results:53.96 percent of neonates in 5～7days after delivery＜35 score as compared to 46.05%neonates≥35 score;21.05%neonates in 12～14 days after delivery＜35 score,as compared to 78.95%≥35 score;14.47% neonates in 24～28 day after delivery＜35 score,to 85.53%nonates≥35 score. Scores of the NBNA raise with the days increase.After all the newbom completed follow-up visit of 12 month,The MDI results of group A is 92.027±8.48 and PDI is 92.027±8.48.The MDI results of Group B is 87.844±7.89,PDI is 88.500±8.474,The MDI results of Group C is 83.821±8.693,PDI is 84.231±9.068.Group A and group B are better then group C.While Group A is better then group B after three months' drug treatment.The result of CDCC In three years old is that group A MDI is 97.59±8.441,PDI is 98.16±7.544;group B MDI is 93.55±7.124,PDI is 88.500±8.474;group C MDI is 88.94±7.586,PDI is 89.75±7.304.Group A and group B are better then group C while group A compared group B is not significant difference,but the MDI results of group A is higher the group B in the baby is 3 years old. Conclusion 1):THE score of NBNA is highly abnormal in the earlier stage of the HIE, and increased as therapy be done for 2 weeks.Neonate with abnormal score after 2weeks still can get it recover through further treatment,yet neonate with score lower than 35 in 24-28days after delivery will prognosis mala.2)Neonates with medium and severe HIE should receive continual combined therapy so that they might get better level of mental and physical developments.Drug therapy and early intervention are better than that only drug therapy,especially for mental development,though no significance is found for psychological development.
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