阅读说明：本技术 一种新生儿缺氧缺血性脑病早期诊断方法 (Early diagnosis method for neonatal hypoxic-ischemic encephalopathy ) 是由 刘俐 陆平翰宗 于 2020-12-30 设计创作，主要内容包括：一种新生儿缺氧缺血性脑病早期诊断方法,其方法在于,所述新生儿出生后出现原始反射异常的表现为拥抱反射过分活跃,减弱或消失；所述新生儿出生后出现吮吸反射异常的表现为吸吮反射减弱或消失；该发明所提供的诊断方法,拥有着完善的诊断方式,通过对新生儿缺氧缺血性脑病前期的临床观察,进行初步的诊断,通过对新生儿进行后期精确的缺氧缺血性脑病检查,便于做出高度准确的早期诊断,避免出现误诊；在颅脑超声检查、CT检查和脑电图检查中,利用相应的精准设备仪器进行辅助检查,帮助提高诊断结果的准确性、无误性；最后再根据新生儿出生后三天的症状表现进行缺氧缺血性脑病的临床分度,便于后期治疗。(A newborn infant hypoxic ischemic encephalopathy early diagnosis method is characterized in that the appearance of original reflex abnormality after birth of the newborn infant shows that the hug reflex is excessively active, weakened or disappeared; the abnormal sucking reflex appears after the birth of the newborn and is represented as the weakening or disappearance of the sucking reflex; the diagnosis method provided by the invention has a perfect diagnosis mode, carries out primary diagnosis by clinical observation on the early stage of the neonatal hypoxic-ischemic encephalopathy, and carries out accurate hypoxic-ischemic encephalopathy examination on the late stage of the neonatal, thereby facilitating the high-accuracy early diagnosis and avoiding misdiagnosis; in the craniocerebral ultrasonic examination, the CT examination and the electroencephalogram examination, the corresponding precise equipment is utilized to carry out auxiliary examination, which helps to improve the accuracy and the correctness of a diagnosis result; finally, the clinical graduation of the hypoxic-ischemic encephalopathy is carried out according to the three-day symptoms of the newborn after birth, so as to facilitate the later treatment.)

1. An early diagnosis method of neonatal hypoxic-ischemic encephalopathy, comprising the following steps:

s1: the newborn anaerobic ischemic encephalopathy early stage observation and judgment: the important observation is respectively carried out before, during and after the birth of the newborn; observing whether the fetus before birth has hypoxia and intrauterine distress; observing whether the newborn has asphyxia during birth; observing whether the newborn has abnormal consciousness, limb abnormality, original reflex abnormality and abnormal sucking after birth;

s2: accurate diagnosis of late stage hypoxic ischemic encephalopathy of newborn: carrying out craniocerebral ultrasonic examination, CT examination and electroencephalogram examination on the newborn with abnormal phenomena observed in the early stage; performing brain diagnosis on the neonate through craniocerebral ultrasonic examination and CT examination to determine whether the neonate has hypoxic ischemic encephalopathy and whether cerebral edema and intracerebroventricular hemorrhage coexist; the method comprises the steps of (1) carrying out electroencephalogram examination on a newborn for a period of time to confirm whether abnormal symptoms exist in the brain of the newborn; in the electroencephalogram examination process, the scalp needs to be cleaned, the vernix caseosa needs to be removed, the resistance of a scalp electrode is less than 10 kilo-ohm, and the paper feeding speed is 15 mm/s;

s3: clinical graduation of hypoxic ischemic encephalopathy of newborn; through careful dynamic observation of neurological symptoms of the newborn within three days after birth, and sub-graduation is carried out on the neurological symptoms; the symptoms of the newborn are most obviously mild within 24 hours after birth; the symptoms are most clearly moderate within 24 to 72 hours after birth of the neonate; the symptoms of the newborn are most obviously severe from birth to 72 hours.

2. The method of claim 1, wherein the fetal intrauterine distress is marked by a decrease in fetal movement, a slowing of fetal heart rate of < 100/min, and a turbidity above III degree in amniotic fluid contaminated by meconium.

3. The method of claim 1, wherein the abnormal consciousness of the newborn after birth is characterized by excessive excitation, lethargy or even coma; the abnormal limbs of the newborn are characterized by weakened, soft and weak tension; the abnormal original reflex after the birth of the newborn shows that the hug reflex is excessively active, weakened or disappeared; the abnormal sucking reflex appears after the birth of the newborn and is represented by the weakening or disappearance of the sucking reflex.

4. The method of claim 1, wherein the cerebral ultrasonography is performed on the brain to indicate the presence of cerebral edema, which is manifested by mild echogenicity widely and uniformly distributed in the brain parenchyma, with narrowing or disappearance of ventricles, sulcus and hemispheric gland, and reduction of cerebral artery pulsation; the brain ultrasonic examination indicates that the basal ganglia and thalamus are injured and are represented by bilaterally symmetrical strong echogenic reflection of the basal ganglia and thalamus; the brain ultrasonic examination indicates that the cerebral aorta and the branch infarctions thereof exist, and the cerebral aorta distribution area has local strong echo reflection.

5. The method for early diagnosis of hypoxic-ischemic encephalopathy of newborn according to claim 1, wherein CT value of white matter is determined by CT scan during CT examination; the white matter CT value of the brain of the full-term infant is higher than 20Hu, the normal state is, the white matter CT value of the brain of the full-term infant is lower than 20Hu, and the low density is; the occipital region of the premature infant and the frontal region of the term infant in the CT examination exhibit low density as normal; the cerebral edema in the CT examination is characterized in that bilateral cerebral hemispheres are in diffuse low-density shadows, and ventricles of the brain become narrow or even disappear; the injury of basal ganglia and thalamus in the CT examination is represented by symmetrical density increase of bilateral basal ganglia and thalamus; the infarction of the aorta and the branch thereof in the CT examination is characterized in that the density of brain tissues is reduced in the distribution area of the cerebral aorta; the periventricular leukomalacia in the CT examination is manifested by symmetric low-density areas around the ventricles and above and outside the lateral anterior horn of the ventricles.

6. The method for early diagnosis of hypoxic-ischemic encephalopathy of newborn according to claim 5, wherein the low-density distribution range of white matter in CT examination can be classified into mild, moderate and severe; wherein mild means that 2 brain leaves are distributed in low-density shadow of focal; moderate means that the low density shadow exceeds 2 brain leaves and the white matter contrast is fuzzy; severe refers to diffuse low-density shadows with a missing gray matter white boundary.

7. The method of claim 1, wherein the mild symptoms of said neonatal hypoxic-ischemic encephalopathy in the clinical compartment are hyperexcitability, tremor of the limbs, normal or elevated muscle tone of the limbs, active hug reflex and suck reflex, no convulsions, regular respiration, no change in the pupil, and normal electroencephalogram; the moderate symptoms in the clinical graduation of the neonatal hypoxic-ischemic encephalopathy are sleepiness, slow response, reduced limb muscle tension, weakened embrace reflex and sucking reflex, convulsion, irregular respiration, miosis, electroencephalogram with low voltage and convulsion activity symptoms; severe symptoms in the clinical graduation of the neonatal hypoxic-ischemic encephalopathy are manifested by loose and soft muscle tension of limbs, disappearance of hug reflex and suck reflex, repeated convulsion, irregular respiration, asymmetric pupil, disappearance of light response, and the electroencephalogram shows burst inhibition or equipotential waveform.

Technical Field

The invention relates to the technical field of medical treatment, in particular to an early diagnosis method for neonatal hypoxic-ischemic encephalopathy.

Background

The neonatal ischemic-hypoxic encephalopathy refers to cerebral ischemic-hypoxic injury caused by hypoxia in perinatal period, cerebral blood flow reduction or short-term cerebral blood flow perfusion interruption, presents a series of clinical symptoms and physical signs of central nervous abnormality, is a common cause seriously threatening the health of neonates and causing death of the neonates and children disability, according to statistics, 1800 to 2000 million infants are born in China every year, the incidence rate of the apnea is 13.9%, 15 to 25 percent of the infants are dead in the neonatal period, up to 25 percent of the infants survive and have permanent psychosocial disturbance in the later growth process, the cause of the serious consequence is closely related to whether early intervention is carried out or not and whether early intervention is carried out or not besides the occurrence and development factors of the disease per se, however, many early diagnosis methods for hypoxic ischemic encephalopathy of newborn are not perfect, and the condition cannot be diagnosed clearly and treated in time, so that the best period of treatment is missed.

Disclosure of Invention

The technical problem to be solved by the invention is to provide an early diagnosis method for the hypoxic-ischemic encephalopathy of the newborn, which can effectively solve the problems in the background technology.

In order to solve the problems, the technical scheme adopted by the invention is as follows: an early diagnosis method of neonatal hypoxic-ischemic encephalopathy, comprising the following steps:

s1, observation and judgment of the neonatal hypoxia-ischemic encephalopathy at the early stage: the important observation is respectively carried out before, during and after the birth of the newborn; observing whether the fetus before birth has hypoxia and intrauterine distress; observing whether the newborn has asphyxia during birth; observing whether the newborn has abnormal consciousness, limb abnormality, original reflex abnormality and abnormal sucking after birth;

s2, accurate diagnosis of late stage hypoxic-ischemic encephalopathy of newborn: carrying out craniocerebral ultrasonic examination, CT examination and electroencephalogram examination on the newborn with abnormal phenomena observed in the early stage; performing brain diagnosis on the neonate through craniocerebral ultrasonic examination and CT examination to determine whether the neonate has hypoxic ischemic encephalopathy and whether cerebral edema and intracerebroventricular hemorrhage coexist; the method comprises the steps of (1) carrying out electroencephalogram examination on a newborn for a period of time to confirm whether abnormal symptoms exist in the brain of the newborn; in the electroencephalogram examination process, the scalp needs to be cleaned, the vernix caseosa needs to be removed, the resistance of a scalp electrode is less than 10 kilo-ohm, and the paper feeding speed is 15 mm/s;

s3, clinical graduation of neonatal hypoxic-ischemic encephalopathy; through careful dynamic observation of neurological symptoms of the newborn within three days after birth, and sub-graduation is carried out on the neurological symptoms; the symptoms of the newborn are most obviously mild within 24 hours after birth; the symptoms are most clearly moderate within 24 to 72 hours after birth of the neonate; the symptoms of the newborn are most obviously severe from birth to 72 hours.

As a further preferred scheme of the invention, the intrauterine fetal distress is characterized by obviously reduced fetal movement, slow fetal heart rate of less than 100/min and turbid amniotic fluid polluted by meconium above III degree.

As a further preferred scheme of the invention, the abnormal consciousness of the newborn after birth is characterized by overexcitation, lethargy and even coma; the abnormal limbs of the newborn are characterized by weakened, soft and weak tension; the abnormal original reflex after the birth of the newborn shows that the hug reflex is excessively active, weakened or disappeared; the abnormal sucking reflex appears after the birth of the newborn and is represented by the weakening or disappearance of the sucking reflex.

As a further preferred aspect of the present invention, the presence of cerebral edema in the craniocerebral ultrasonography is manifested by mild echogenicity widely and uniformly distributed in the brain parenchyma, with narrowing or disappearance of the ventricles, sulcus and hemispheric fissure, and a decrease in the pulsation of cerebral arteries; the brain ultrasonic examination indicates that the basal ganglia and thalamus are injured and are represented by bilaterally symmetrical strong echogenic reflection of the basal ganglia and thalamus; the brain ultrasonic examination indicates that the cerebral aorta and the branch infarctions thereof exist, and the cerebral aorta distribution area has local strong echo reflection.

In a further preferred embodiment of the present invention, in the CT examination, CT scan is performed to determine the CT value of the white brain matter; the white matter CT value of the brain of the full-term infant is higher than 20Hu, the normal state is, the white matter CT value of the brain of the full-term infant is lower than 20Hu, and the low density is; the occipital region of the premature infant and the frontal region of the term infant in the CT examination exhibit low density as normal; the cerebral edema in the CT examination is characterized in that bilateral cerebral hemispheres are in diffuse low-density shadows, and ventricles of the brain become narrow or even disappear; the injury of basal ganglia and thalamus in the CT examination is represented by symmetrical density increase of bilateral basal ganglia and thalamus; the infarction of the aorta and the branch thereof in the CT examination is characterized in that the density of brain tissues is reduced in the distribution area of the cerebral aorta; the periventricular leukomalacia in the CT examination is manifested by symmetric low-density areas around the ventricles and above and outside the lateral anterior horn of the ventricles.

As a further preferable scheme of the invention, the low-density distribution range of the white matter in the CT examination can be divided into mild, moderate and severe; wherein mild means that 2 brain leaves are distributed in low-density shadow of focal; moderate means that the low density shadow exceeds 2 brain leaves and the white matter contrast is fuzzy; severe refers to diffuse low-density shadows with a missing gray matter white boundary.

As a further preferred embodiment of the present invention, the mild symptoms in the clinical graduation of said neonatal hypoxic-ischemic encephalopathy are manifested by hyperexcitability, tremor of the limbs, normal or increased muscle tone of the limbs, active hug reflex and suck reflex, no convulsion, regular breathing, no change in the pupil, normal electroencephalogram; the moderate symptoms in the clinical graduation of the neonatal hypoxic-ischemic encephalopathy are sleepiness, slow response, reduced limb muscle tension, weakened embrace reflex and sucking reflex, convulsion, irregular respiration, miosis, electroencephalogram with low voltage and convulsion activity symptoms; severe symptoms in the clinical graduation of the neonatal hypoxic-ischemic encephalopathy are manifested by loose and soft muscle tension of limbs, disappearance of hug reflex and suck reflex, repeated convulsion, irregular respiration, asymmetric pupil, disappearance of light response, and the electroencephalogram shows burst inhibition or equipotential waveform.

Compared with the prior art, the invention provides an early diagnosis method for the hypoxic-ischemic encephalopathy of the newborn, which has the following beneficial effects:

the diagnosis method provided by the invention has a perfect diagnosis mode, carries out primary diagnosis by clinical observation on the early stage of the neonatal hypoxic-ischemic encephalopathy, and carries out accurate hypoxic-ischemic encephalopathy examination on the late stage of the neonatal, thereby facilitating the high-accuracy early diagnosis and avoiding misdiagnosis; in the craniocerebral ultrasonic examination, the CT examination and the electroencephalogram examination, the corresponding precise equipment is utilized to carry out auxiliary examination, which helps to improve the accuracy and the correctness of a diagnosis result; finally, the clinical graduation of the hypoxic-ischemic encephalopathy is carried out according to the three-day symptoms of the newborn after birth, so as to facilitate the later treatment.

Drawings

FIG. 1 is a partial schematic view of the process of the present invention.

Detailed Description

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments.

The invention provides an early diagnosis method of neonatal hypoxic-ischemic encephalopathy, which comprises the following steps:

s1, observation and judgment of the neonatal hypoxia-ischemic encephalopathy at the early stage: the important observation is respectively carried out before, during and after the birth of the newborn; observing whether the fetus before birth has hypoxia and intrauterine distress; observing whether the newborn has asphyxia during birth; observing whether the newborn has abnormal consciousness, limb abnormality, original reflex abnormality and abnormal sucking after birth;

s2, accurate diagnosis of late stage hypoxic-ischemic encephalopathy of newborn: carrying out craniocerebral ultrasonic examination, CT examination and electroencephalogram examination on the newborn with abnormal phenomena observed in the early stage; performing brain diagnosis on the neonate through craniocerebral ultrasonic examination and CT examination to determine whether the neonate has hypoxic ischemic encephalopathy and whether cerebral edema and intracerebroventricular hemorrhage coexist; the method comprises the steps of (1) carrying out electroencephalogram examination on a newborn for a period of time to confirm whether abnormal symptoms exist in the brain of the newborn; in the electroencephalogram examination process, the scalp needs to be cleaned, the vernix caseosa needs to be removed, the resistance of a scalp electrode is less than 10 kilo-ohm, and the paper feeding speed is 15 mm/s;

s3, clinical graduation of neonatal hypoxic-ischemic encephalopathy; through careful dynamic observation of neurological symptoms of the newborn within three days after birth, and sub-graduation is carried out on the neurological symptoms; the symptoms of the newborn are most obviously mild within 24 hours after birth; the symptoms are most clearly moderate within 24 to 72 hours after birth of the neonate; the symptoms of the newborn are most obviously severe from birth to 72 hours.

As a further preferred scheme of the invention, the intrauterine fetal distress is characterized by obviously reduced fetal movement, slow fetal heart rate of less than 100/min and turbid amniotic fluid polluted by meconium above III degree.

As a further preferred scheme of the invention, the abnormal consciousness of the newborn after birth is characterized by overexcitation, lethargy and even coma; the abnormal limbs of the newborn are characterized by weakened, soft and weak tension; the abnormal original reflex after the birth of the newborn shows that the hug reflex is excessively active, weakened or disappeared; the abnormal sucking reflex appears after the birth of the newborn and is represented by the weakening or disappearance of the sucking reflex.

As a further preferred aspect of the present invention, the presence of cerebral edema in the craniocerebral ultrasonography is manifested by mild echogenicity widely and uniformly distributed in the brain parenchyma, with narrowing or disappearance of the ventricles, sulcus and hemispheric fissure, and a decrease in the pulsation of cerebral arteries; the brain ultrasonic examination indicates that the basal ganglia and thalamus are injured and are represented by bilaterally symmetrical strong echogenic reflection of the basal ganglia and thalamus; the brain ultrasonic examination indicates that the cerebral aorta and the branch infarctions thereof exist, and the cerebral aorta distribution area has local strong echo reflection.

In a further preferred embodiment of the present invention, during the CT examination, CT scanning is performed to determine the CT value of the white brain matter, and the white brain matter CT value of the term infant is more than 20Hu, which is normal; the white matter CT value of the brain of the term infant is lower than 20Hu, and the density is low; the occipital region of the premature infant and the frontal region of the term infant in the CT examination exhibit low density as normal; the cerebral edema in the CT examination is characterized in that bilateral cerebral hemispheres are in diffuse low-density shadows, and ventricles of the brain become narrow or even disappear; the injury of basal ganglia and thalamus in the CT examination is represented by symmetrical density increase of bilateral basal ganglia and thalamus; the infarction of the aorta and the branch thereof in the CT examination is characterized in that the density of brain tissues is reduced in the distribution area of the cerebral aorta; the periventricular leukomalacia in the CT examination is manifested by symmetric low-density areas around the ventricles and above and outside the lateral anterior horn of the ventricles.

As a further preferable scheme of the invention, the low-density distribution range of the white matter in the CT examination can be divided into mild, moderate and severe; wherein mild means that 2 brain leaves are distributed in low-density shadow of focal; wherein moderate means that the low density shadow exceeds 2 brain leaves and the white matter contrast is fuzzy; wherein the severe degree refers to diffuse low density shadow and the gray matter white matter boundary disappears.

As a further preferred embodiment of the present invention, the mild symptoms in the clinical graduation of said neonatal hypoxic-ischemic encephalopathy are manifested by hyperexcitability, tremor of the limbs, normal or increased muscle tone of the limbs, active hug reflex and suck reflex, no convulsion, regular breathing, no change in the pupil, normal electroencephalogram; the moderate symptoms in the clinical graduation of the neonatal hypoxic-ischemic encephalopathy are sleepiness, slow response, reduced limb muscle tension, weakened embrace reflex and sucking reflex, convulsion, irregular respiration, miosis, electroencephalogram with low voltage and convulsion activity symptoms; severe symptoms in the clinical graduation of the neonatal hypoxic-ischemic encephalopathy are manifested by loose and soft muscle tension of limbs, disappearance of hug reflex and suck reflex, repeated convulsion, irregular respiration, asymmetric pupil, disappearance of light response, and the electroencephalogram shows burst inhibition or equipotential waveform.

As a specific embodiment of the present invention:

first, a preliminary clinical diagnosis of hypoxic-ischemic encephalopathy in newborns is required: checking whether abnormal obstetric history of intrauterine hypoxia of the fetus exists or not and severe intrauterine fetal distress manifestations, if fetal movement is obviously reduced, fetal heart becomes slow to be less than 100/min, and fetal feces pollute amniotic fluid and are turbid above III ℃; whether the newborn has asphyxia during birth, particularly severe asphyxia, for example, Apgar scores for 1 minute or less and 3 minutes or less and 5 minutes or less and 6 minutes or less, spontaneous breathing starts after rescue for 10 minutes, and the newborn needs to be breathed for more than 2 minutes by the positive pressure of an endotracheal intubation; within 12 hours after birth of the neonate: whether the manifestations of disturbance of consciousness, such as overexcitation, lethargy and even coma, appear; changes in limb muscle tone, such as decreased tension, flaccidity; the original reflection is abnormal, such as the hug reflection is excessively active, weakened or disappeared; the suck reflex is weakened or disappeared; in addition, convulsion or frequent convulsion sometimes occur in severe cases, and fontanel tension is increased due to cerebral edema; when severe cases occur, brainstem symptoms sometimes occur, such as central respiratory failure conditions of irregular respiratory rhythm, slow respiration, apnea and the like, miosis or dilation, slow response to light, even disappearance, and nystagmus of partial children patients; attention should be paid to distinction from productive intracranial hemorrhage, with the exception of intrauterine infectious encephalitis and congenital malformations of the central nervous system.

The second step is to use corresponding precise examination equipment to carry out further auxiliary examination on the neonatal hypoxic-ischemic encephalopathy: among them are craniocerebral ultrasound examination, CT examination and electroencephalogram examination; when performing craniocerebral ultrasonic examination: mild echogenic enhancement, widely and uniformly distributed within the brain parenchyma, with narrowing or disappearance of ventricles, sulci and hemispheric fissured glands and reduced pulsation of cerebral arteries, was found to indicate the presence of cerebral edema; when the basal ganglia and thalamus present bilateral symmetry hyperechoic reflections, it indicates the presence of basal ganglia and thalamic damage; when local strong echo reflection appears in the cerebral artery distribution area, the infarction of the cerebral aorta and the branches thereof is shown; when CT examination is carried out: during CT scanning, the CT value of brain parenchyma is measured, and the CT value of the white matter of normal term infant brain is higher than 20Hu and lower than 18Hu, and the low density is obtained; it is then necessary to rule out the normal hypodensism associated with neonatal brain development, i.e. the presence of hypodensism in the occipital region of premature infants and in the frontal region of term infants. Bilateral cerebral hemispheres present diffuse low-density shadows, and ventricles of brain become narrow or even disappear, indicating the existence of cerebral edema; when the bilateral basal ganglia and thalamus are symmetrically increased in density, the basal ganglia and thalamus are damaged, and the basal ganglia and thalamus are often coexisted with cerebral edema; the density of brain tissues is reduced in the distribution area of the cerebral aorta, which indicates that the aorta and the branch thereof are infarcted; a symmetric low-density area appears around the ventricles of the brain, particularly above the anterior horn of the lateral ventricles of the brain, which prompts the softening of white matter around the ventricles of the brain, often accompanied by intracerebroventricular hemorrhage and frequent premature infants; according to CT examination, the distribution range of low density of white matter can be divided into light, medium and heavy 3 degrees, the Cr graduation is not completely consistent with the clinical graduation, the serious low density appears after 2 to 3 weeks, and the CT value is less than 8Hu to 10Hu, so that a certain relation is formed with prognosis; when electroencephalogram examination is performed: the electroencephalogram is mainly characterized by background activity abnormality, low voltage is adopted, the voltage is less than 10 pV to 15pV in any state, and the phenomena of equipotential or electrical rest and outbreak suppression are most common; the abnormal degree of electroencephalogram detected in 1 week after birth of the newborn is basically consistent with clinical graduation, and the electroencephalogram still has no remarkable improvement after 2 to 3 weeks; in the electroencephalogram examination process, the scalp is cleaned and the vernix caseosa is removed, so that the resistance of a scalp electrode is less than 10 kilo-ohms, and the paper feeding speed is 15 mm/s; in CT examination, mild means scattered in 2 brain lobes with focal low-density shadows, moderate means that the low-density shadows exceed 2 brain lobes, the contrast of white matter gray matter is fuzzy, severe means diffuse low-density shadows, gray matter white matter boundaries disappear, but basal ganglia and cerebellum have normal density, and moderate and severe means are often accompanied by subarachnoid hemorrhage, intracerebroventricular hemorrhage or cerebral parenchyma hemorrhage; in addition to the reference of obstetrical history, the clinical manifestations of intracranial hemorrhage at different sites should be familiar, and CT examination should be performed in time to further confirm the diagnosis.

The third step is to carry out clinical graduation to the neonatal hypoxia-ischemia encephalopathy: when the neurological symptoms gradually worsen after the birth of a newborn, the phenomenon that excitation is transformed into inhibition or even coma can occur in some cases, the highest degree can be achieved in 72 hours, and the symptoms gradually improve and recover after 72 hours; the clinician should do careful dynamic observation to the neurological symptoms within 3 days after birth of the neonate and give sub-divisions; mild symptoms are hyperexcitability, limb tremor, normal or heightened limb muscle tension, active hug reflex and suck reflex, no convulsion, regular breathing, no change in pupil, and normal electroencephalogram; the moderate symptoms are sleepiness, slow response, reduced limb muscle tension, weakened hugging reflex and sucking reflex, convulsion, irregular respiration, miosis, low voltage of electroencephalogram and convulsion activity symptoms; severe symptoms are manifested by a flaccid muscle tone of the limbs, disappearance of the hugging and sucking reflexes, recurrent convulsions, irregular breathing, asymmetric pupils, disappearance of the photoreaction and appearance of a burst suppression or equipotential waveform in the electroencephalogram.

The above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.