选择性头部亚低温联合纳洛酮治疗新生儿窒息疗效分析  

Analysis on efficacy of selective head mild hypothermia combined with naloxone in the treatment of neonates asphyxia

作　　者：赵一品 李小雪 胡双双 李雅琪 ZHAO Yipin;LI Xiaoxue;HU Shuangshuang;LI Yaqi(Department of Neonatology,Zhoukou Maternal and Child Health Hospital,Zhoukou 466000,Henan,China;Department of Pediatrics,Zhoukou Hospital of Traditional Chinese Medicine,Zhoukou 466000,Henan,China)

机构地区：[1]河南省周口市妇幼保健院〔周口市儿童医院〕新生儿科,河南周口466000 [2]河南省周口市中医院儿科,河南周口466000

出　　处：《右江医学》2022年第8期609-613,共5页Chinese Youjiang Medical Journal

摘　　要：目的探究选择性头部亚低温联合纳洛酮治疗新生儿窒息(neonates asphyxia,NA)的效果。方法前瞻性收集周口市妇幼保健院2016年1月—2021年1月112例新生儿窒息患儿,按治疗方案不同分成A组(n=56)、B组(n=56)。B组在常规基础上给予纳洛酮治疗,A组于B组基础上予以选择性头部亚低温治疗。对比两组总有效率、治疗前及治疗7 d后血清二胺氧化酶(DAO)、肠脂肪酸结合蛋白(FABP)、可溶性Fas(sFas)、可溶性Fas配体(sFasL)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平、不良预后发生率。结果A组总有效率91.07%(51/56)较B组76.79%(43/56)高(P<0.05);治疗7 d后,A组血清DAO、FABP、sFas、sFasL、MDA水平较B组低(P<0.001),血清SOD水平较B组高(P<0.001);A组不良预后发生率明显低于B组(P<0.05)。结论选择性头部亚低温联合纳洛酮辅助治疗新生儿窒息可进一步提高疗效,抑制细胞凋亡,减轻氧化应激反应,还可通过调节血清DAO、FABP水平改善胃肠功能。Objective To explore the effect of selective head mild hypothermia combined with naloxone in the treatment of neonates asphyxia(NA).Methods 112 cases of NA admitted to Zhoukou Maternal and Child Health Hospital from January 2016 to January 2021 were prospectively collected and divided into group A(n=56)and group B(n=56)according to different treatment plans.Group B were treated with naloxone on the basis of routine treatment,and group A were treated with selective mild head hypothermia on the basis of group B.And then,the total effective rates as well as the levels of serum diamine oxidase(DAO),intestinal fatty acid binding protein(FABP),soluble Fas(sFas),soluble Fas ligand(sFasL),superoxide dismutase(SOD),malondialdehyde(MDA)before and 7 days after treatment and the incidence of adverse prognosis were compared between the two groups.Results The total effective rate in the group A was 91.07%(51/56),which was higher than that in the group B(76.79%,43/56)(P<0.05).After 7 days of treatment,the levels of serum DAO,FABP,sFas,sFasL and MDA in the group A were lower than those in the group B(P<0.001),the level of serum SOD was higher than that of group B(P<0.001).The incidence of poor prognosis in the group A was significantly lower than that in the group B(P<0.05).Conclusion Naloxone combined with selective mild head hypothermia can further improve the curative effect in the adjuvant treatment of neonates asphyxia,inhibit cell apoptosis,reduce oxidative stress,and improve gastrointestinal function by regulating serum DAO and FABP levels.

关 键 词：新生儿窒息 选择性头部亚低温 纳洛酮 细胞凋亡 氧化应激 

分 类 号：R722.12[医药卫生—儿科]