采用负荷量苯巴比妥治疗新生儿缺氧缺血性脑病的临床研究  

Clinical study of loading dose of phenobarbital in neonatal hypoxic-ischemic encephalopathy

作　　者：潘军[1] 胡江[1] 谢集建[1] 李涛[1] 

机构地区：[1]湖北省十堰市太和医院湖北省药学院附属医院儿科,442000

出　　处：《中国医师进修杂志》2011年第36期1-3,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨负荷量苯巴比妥在治疗新生儿缺氧缺血性脑病中的作用。方法将356例新生儿缺氧缺血性脑病患儿按机械抽样法随机分为观察组和对照组，每组178例。两组均给予综合治疗，观察组无论有无惊厥早期应用负荷量苯巴比妥20mg,／kg肌肉注射，12h后给维持量5mg／（kg·d）；对照组则在出现神经系统症状时，应用常规剂量苯巴比妥5mg／（kg·d）。观察两组的短期疗效和长期疗效。结果观察组患儿惊厥发生率为11．2％（20／178），对照组患儿为68．0％（121／178），两组比较差异有统计学意义（r=6．403，P〈0．05）；观察组患儿黄疸发生率为7．9％（14／178），对照组患儿为50．6％（90／178），两组比较差异有统计学意义（r=78．459，P〈0．05）。观察组患儿总有效率为87．1％（155／178），对照组患儿为77．5％（138／178），两组比较差异有统计学意义（r=8．308，P〈0．05）。观察组患儿在各月龄时所测得的DQ评分明显高于对照组患儿，差异有统计学意义（P〈0．05）。两组患儿均随访至18月龄，观察组神经系统后遗症发生率为7．9％（14／178），对照组患儿为28．1％（50／178），两组比较差异有统计学意义（r=29．085，P〈0．05）。结论负荷量苯巴比妥治疗新生儿缺氧缺血性脑病，可控制惊厥的发生并保护神经系统。Objective To investigate the clinical effect of loading dose of phenobarbital in neonatal hypoxic-ischemic encephalopathy （HIE）. Methods Three hundred and fifty-six patients with neonatal HIE were randomly divided into treatment group and control group by systematic sampling,with 178 patients in each group. Two groups were given comprehensive therapy, with or without convalsions,early application of loading dose of phenobarbital in 20 mg/kg intramuscular injection, 12 h beck to a maintenance dose 5 mg/（kg＇d） in treatment group,while a conventional dose of phenobarbital in 5 mg/（kg-d） was used in control group after convulsion happened. Clinical effect of short-term and long-term were observed. Results The rates of eclampsia, choloplania and total effect was 11.2%（20/178）,7.9%（14/178） and 87.1%（155/178） in treatment group, and 68.0% （ 121/178 ）, 50.6% （ 90/178 ） and 77.5% （ 138/178 ） in control group, there were significant differences between two groups （ X2 = 6.403,78.459 and 8.308, P 〈 0.05）. DQ score in treatment group was higher than that in control group （P 〈 0.05 ）. The patients in two groups were followed up to age 18 months, the deformity rate in treatment group [ 7.9% （14/178） ] was lower than that in control group [ 28.1% （50/178） ], there was significant difference between two groups（ ）（2 = 29.085,P 〈 0.05 ）. Conclusion Loading dose of phenobarbital is very effective to treat neonatal HIE.

关 键 词：苯巴比妥 婴儿 新生 缺氧缺血 脑 

分 类 号：R722.12[医药卫生—儿科]