亚低温联合苯巴比妥钠治疗重度新生儿缺氧缺血性脑病的效果观察  

Efficacy of mild hypothermia combined with phenobarbital sodium on severe neonatal hypoxic-ischemic encephalopathy

作　　者：黄玉焕[1] Huang Yuhuan(Department of Neonatology,Nanyang First People’s Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市第一人民医院新生儿科,473000

出　　处：《中国实用医刊》2022年第2期70-73,共4页Chinese Journal of Practical Medicine

摘　　要：目的:探讨亚低温联合苯巴比妥钠治疗重度新生儿缺氧缺血性脑病(HIE)的临床疗效。方法:抽取2019年1月至2020年5月南阳市第一人民医院收治的96例重度HIE患儿为研究对象,按随机数字表法分为对照组和观察组,每组48例。两组均行常规对症治疗,在此基础上,对照组采用苯巴比妥钠治疗,观察组采用亚低温联合苯巴比妥钠治疗。比较两组的临床疗效;比较两组治疗前及治疗14 d时脑组织损伤指标[神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、S100β蛋白]及神经行为评估(NBNA)评分;比较两组不良反应发生情况。结果:治疗后14 d,观察组总有效率(91.67%,44/48)高于对照组(75.00%,36/48), P<0.05。治疗后14 d,两组NSE、MBP、S100β蛋白水平均低于治疗前,NBNA评分均高于治疗前,且观察组变化幅度大于对照组( P<0.05)。治疗期间,两组不良反应发生情况比较差异未见统计学意义( P>0.05)。 结论:亚低温联合苯巴比妥钠治疗重度HIE的疗效显著,能够减轻患儿脑组织损伤,改善神经功能。Objective To investigate the clinical efficacy of mild hypothermia combined with phenobarbital sodium in the treatment of severe neonatal hypoxic-ischemic encephalopathy(HIE).Methods Ninety-six children with severe HIE admitted to Nanyang First People’s Hospital from January 2019 to May 2020 were selected as the research subjects,and they were divided into control group and observation group by random number table method,with 48 cases in each group.Both groups were given conventional symptomatic treatment,on this basis,the control group was treated with phenobarbital sodium,and the observation group was treated with mild hypothermia combined with phenobarbital sodium.The clinical efficacy of the two groups were compared.The indexes of brain tissue injury,including neuron specific enolase(NSE),myelin basic protein(MBP),S100βprotein,and neonatal behavioral neurological assessment(NBNA)score before and 14 days after treatment were compared between the two groups.The occurrence of adverse reactions of the two groups were compared.Results After 14 days of treatment,the total effective rate of the observation group(91.67%,44/48)was higher than that of the control group(75.00%,36/48),P<0.05.After 14 days of treatment,NSE,MBP and S100βof the two groups were lower than those before treatment,NBNA scores were higher than those before treatment,and the change range of the observation group was greater than that of the control group(P<0.05).During the treatment,there was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusions Mild hypothermia combined with phenobarbital sodium has significant efficacy in the treatment of severe HIE,which can reduce brain tissue injury,and improve neurological function of children.

关 键 词：缺氧缺血性脑病 新生儿 亚低温 苯巴比妥钠 脑组织损伤 

分 类 号：R722.1[医药卫生—儿科]