Retrospective Analysis Of Therapeutic Effect And Influencing Factors Of Hyperbaric Oxygen Therapy For Neonatal Hypoxic Ischemic Encephalopathy

Objective:(1)To investigate the hyperbaric oxygen treatment of neonatal hypoxic ischemic encephalopathy(HIE),long-term efficacy,understand the safety of hyperbaric oxygen treatment of HIE;(2)To explore the main factors affecting the curative effect of neonatal hypoxic-ischemic encephalopathy.Methods:Children diagnosed with hypoxic-ischemic encephalopathy in Shenzhen Children’s Hospital from January 2017 to June 2022 who met the inclusion criteria were selected.According to whether to receive Hyperbaric oxygen(HBO)treatment was divided into hyperbaric oxygen group and non-hyperbaric oxygen group.Clinical data of all children were collected,and they were divided into good prognosis group and poor prognosis group according to 1-year-old neurodevelopment.Then,the following studies were conducted:(1)Chi-square test was used to compare the difference in neurodevelopment of HIE children at 1 year old between hyperbaric oxygen group and non-hyperbaric oxygen group,and adverse reactions and severity of hyperbaric oxygen treatment in HIE patients were collected;(2)Univariate and multivariate Logistic regression analysis was used to explore the main factors affecting the efficacy of children with hypoxic-ischemic encephalopathy.Results:(1)A total of 134 children meeting the inclusion criteria were collected in this study,including 84 in the hyperbaric oxygen group and 50 in the non-hyperbaric oxygen group.Among the 134 cases,92 cases had good prognosis and42 cases had poor prognosis.There were 50 cases of mild HIE(37.31%),70 cases of moderate HIE(52.24%)and 14 cases of severe HIE(10.45%).The prognosis of patients with mild HIE was 6%.The poor prognosis rate of patients with moderate HIE was 41.43%.The prognosis of severe HIE patients was 78.57%.The rate of poor prognosis was statistically different(P=0.000).63 patients in hyperbaric oxygen group had good prognosis;There were 29 cases with good prognosis in the non-hyperbaric oxygen group,and the difference of neurological prognosis between the hyperbaric oxygen group and the non-hyperbaric oxygen group was statistically significant(P=0.04).There were 0 cases with adverse reactions during hyperbaric oxygen treatment.(2)Through univariate analysis of the factors affecting the long-term neurodevelopmental prognosis of children in the hyperbaric oxygen group,three items of MR(P=0.035),hyperbaric oxygen treatment course(P=0.032),rehabilitation treatment course(P= 0.048)were found to have statistically significant differences;By multivariate Logistic analysis of the factors affecting the long-term neurodevelopmental prognosis of children in hyperbaric oxygen group,Gestational age(P=0.004,OR=1.917),birth weight(P=0.016,OR=0.143),MRI status(P=0.018,OR=8.321),course of hyperbaric oxygen(P=0.010,OR=0.152),and course of rehabilitation treatment(P=0.043,OR=0.835)were selected the difference was statistically significant.Conclusions:(1)The neurodevelopmental outcome of 1-year-old HIE children treated with hyperbaric oxygen is better,and the hyperbaric oxygen treatment for HIE is effective and safe;(2)Birth weight,normal MRI,hyperbaric oxygen course and rehabilitation course have an impact on the long-term prognosis of HIE children...