目的:觀察神經保護劑及早期干預聯合應用對重癥新生兒高膽紅素血癥神經行為預后的影響。方法:將2007年1月至2008年6月收治重癥新生兒高膽紅素血癥患兒67例隨機分為常規治療組和綜合治療組2組。 常規治療組按照新生兒黃疸干預推薦方案,給與對癥治療;藥物治療;藍光治療;周圍血管法同步換血等常規治療。綜合治療組在常規治療基礎上,同時給與新生兒撫觸1天2次和神經保護劑神經節苷脂20mg/d×10天,并在經搶救治療進入恢復期后,按照《0～3 歲早期干預大綱》采用醫院和家庭相結合的方式從視,聽,觸,運動等各方面給予早期干預至6月齡。兩組患兒均在6月齡采用北京－Gesell嬰幼兒發育診斷量表進行智能測試,比較各組發育商(DQ)。同時對兩組后遺癥發生機率比較。結果:患兒6月齡時,綜合治療組與常規治療組在大運動,語言,個人 社交及適應性4個能區均有顯著差異(Plt;0.01),精細動作能區有明顯差異(Plt;0.05),差別有統計學意義。綜合治療組與常規治療組后遺癥發生率比較(Plt;0.05),差異有統計學意義。結論:急性期神經保護劑及早期干預聯合應用可促進重癥新生兒高膽紅素血癥患兒的智能發育,減少神經行為后遺癥的發生。
Objective To investigate the application effect of a virtual simulation teaching system based on DeepSeek technology in the clinical training of neonatal resuscitation. Methods A total of 48 clinical medicine (“5+3” integrated program) students from the 2020 cohort, interning in the Department of Neonatology of the First Affiliated Hospital of Harbin Medical University between January and June 2025, were selected and randomly divided into a trial group (n=24) and a control group (n=24). The trial group received training using a virtual simulation teaching system integrated with DeepSeek technology, featuring dynamic physiological response, natural language interaction, and hierarchical intelligent feedback. The control group received traditional virtual simulation teaching. After 6 hours of teaching, outcomes were evaluated through theoretical assessments, objective structured clinical examination (OSCE), key decision-making accuracy, and teaching satisfaction questionnaires. Results The theoretical score (93.5±3.3 vs. 84.7±4.9), OSCE score (95.3±2.6 vs. 86.1±4.3), and key decision-making accuracy [(91.6±3.7)% vs. (77.3±6.4)%] of the trial group were significantly higher than those of the control group (P<0.001). The trial group outperformed the control group in all OSCE subdomain scores (rapid assessment and initial resuscitation: 24.1±1.0 vs. 21.3±2.2; positive pressure ventilation: 23.8±1.2 vs. 20.1±2.1; chest compressions: 18.9±1.1 vs. 16.2±1.8; drug therapy: 14.3±0.9 vs. 12.0±1.5; teamwork and communication: 14.2±0.8 vs. 11.5±1.6) and in the accuracy rates for all key decision points [whether to initiate initial resuscitation: (93.8±4.5)% vs. (82.1±8.7)%; whether to initiate positive pressure ventilation: (92.9±5.3)% vs. (79.6±10.2)%; whether to correct ventilation: (90.4±6.1)% vs. (75.0±11.5)%; whether to initiate chest compressions (94.2±5.1)% vs. (70.8±12.3)%; whether to use epinephrine: (92.5±6.2)% vs. (68.3±14.1)%], with all differences being statistically significant (P<0.001). The teaching satisfaction survey showed that the satisfaction rates in the trial group for the dimensions of immersion (95.8% vs. 54.2%), knowledge understanding (91.7% vs. 58.3%), skill improvement (91.7% vs. 62.5%), decision-making logic (95.8% vs. 50.0%), feedback effectiveness (95.8% vs. 41.7%), and learning confidence (91.7% vs. 45.8%) were all significantly higher than those in the control group (P<0.05). Conclusion The DeepSeek-based virtual simulation teaching system can effectively enhance the quality of neonatal resuscitation training, significantly improving students’ clinical decision-making abilities, operational skills, and teamwork competence, demonstrating good application prospects in medical education.