Effect of cephalic sub-hypothermia therapy combined with ganglioside on neonates with hypoxic-ischemic encephalopathy

Objective To investigate the effects of cephalic sub-hypothermia therapy combined with ganglioside injection in treatment of neonatal hypoxic ischemic encephalopathy (HIE). Methods A total of 74 cases with HIE treated in our hospital from January 2012 to May 2013 were randomly divided into treatment group (n=38) and control group (n=36).The neonates in the control group were treated by cephalic sub-hypothermia,while the neonates in the observation group were treated by sub-hypothermia combined with ganglioside.The serum neuron specific enolase (NSE) level at 7 d after birth,and neonatal behavioral neurological assessment (NBNA) at 7 d and 28 d after birth,Bayley scales of infant development at 18 months,WPPSI-Ⅲ score at 6 years and survival were compared between the two groups. Results After treatment,there was no significant difference between the treatment group and the control group in NSE serum level (12.94±2.87 vs 13.27±3.05) and NBNA score (31.42±3.75 vs 31.81±4.02) at 7 d after birth (P>0.05,respectively).However,the NBNA score of the treatment group was significantly higher than that of the control group (35.03±2.12 vs 33.61±2.61,P=0.012) at 28 d after birth,and the mental development indexes (MDI) (91.11±15.09 vs 82.69±12.95) and the psychomotor developmental indexes (90.39±13.00 vs 81.78±14.70) in treatment group were also higher than those in the control group (P<0.05,respectively).At 6 years old,the IQ score of the treatment group was higher than that of the control group (83.58±18.92 vs 72.93±15.65,P=0.024);the number of children with IQ≤70 in the treatment group was significantly less than those in the control group (11 vs 17),and the number of children with IQ≥85 in the treatment group was significantly higher than those in the control group (18 vs 8) (P<0.05,respectively).There was no significant difference in the survival rate at 18 months (94.74% vs 88.88%) and 6 years (81.58% vs 75.00%) between the two groups. Conclusion Sub-hypothermia therapy combined with ganglioside can improve the short-term and medium-term neurobehavioral function and long-term mental development of children with HIE,which has a good prospect for application.