全身亚低温联合神经节苷酯对新生儿缺氧缺血性脑病患儿神经功能和后遗症的影响研究  

Effects of Whole-body Mild Hypothermia Combined with Gangliosides on Neurological Function and Sequelae of Neonatal Hypoxic-ischemic Encephalopathy

作　　者：陈志强 周建福[1] 潘素香 郑碧娟 蔡燕萍 林志彬 CHEN Zhiqiang;ZHOU Jianfu;PAN Suxiang;ZHENG Bijuan;CAI Yanping;LIN Zhibin(Department of Pediatrics,Affiliated Hospital of Putian University,Putian,Fujian Province,351100 China)

机构地区：[1]莆田学院附属医院儿科,福建莆田351100

出　　处：《中外医疗》2023年第12期43-46,59,共5页China & Foreign Medical Treatment

基　　金：莆田市科技计划项目(2020S3F005)。

摘　　要：目的讨论研究全身亚低温联合神经节苷脂对缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)新生儿神经功能及后遗症的影响。方法简单随机选择2019年1月—2022年1月莆田学院附属医院收治的HIE患儿80例作为研究对象,并以随机数表法分为对照组与观察组,各40例。两组患儿均接受常规治疗,对照组在此基础上应用全身亚低温治疗,观察组在对照组基础上联合注射用单唾液酸四己糖神经节苷脂(monosialotetrahexosyl ganglioside,GM1)静脉滴注治疗。比较两组患儿治疗前后新生儿行为神经测定(neonatal behavioral neurological assessment,NBNA)评分及治疗后后遗症发生情况。结果观察组治疗后NBNA各项评分(9.2±1.1)分、(6.4±0.9)分、(6.3±0.6)分、(5.2±0.7)分、(5.2±0.4)分均显著优于对照组(7.3±1.2)分、(5.1±0.4)分、(4.9±0.4)分、(4.0±0.7)分、(4.4±0.5)分,差异有统计学意义(t=7.381、8.348、12.278、7.666、7.901,P<0.05)。并发症发生人数7例(17.5%)显著少于对照组16例(40.0%),差异有统计学意义(χ^(2)=3.905,P<0.05)。结论对HIE患儿联合全身亚低温及GM1治疗效果显著,不仅可有效改善患儿神经功能,促进神经组织修复与再生,更有助于提高其发育商并降低智力低下、脑瘫等后遗症发生风险,对促进患儿恢复及预后可发挥较好的作用,具有较高的临床应用价值。Objective To discuss and study the effects of whole-body mild hypothermia combined with gangliosides on the neurological function and sequelae of newborns with hypoxic-ischemic encephalopathy(HIE).Methods A total of 80 children with HIE who were admitted to the Affiliated Hospital of Putian University from January 2019 to January 2022 were randomly selected as the research objects and divided into the control group and the observation group by random number method,40 cases in each group.Both groups received routine treatment,the control group was treated with systemic mild hypothermia on the basis of this,and the observation group was treated with intravenous infusion of monosialotetrahexosyl ganglioside(GM1)on the basis of the control group.The neonatal behavioral neurological assessment(NBNA)score and the occurrence of sequelae after treatment were compared between the two groups before and after treatment.Results After treatment in the observation group,the NBNA scores were(9.2±1.1)points,(6.4±0.9)points,(6.3±0.6)points,(5.2±0.7)points,(5.2±0.4)points,all significantly better than those in the control group(7.3±1.2)points,(5.1±0.4)points,(4.9±0.4)points,(4.0±0.7)points,(4.4±0.5)points,the difference was statistically significant(t=7.381,8.348,12.278,7.666,7.901,P<0.05).The number of complications occurred in 7 cases(17.5%)was significantly less than 16 cases(40.0%)in the control group,the difference was statistically significant(χ^(2)=3.905,P<0.05).Conclusion The combined treatment of whole body mild hypothermia and GM1 has a significant effect on children with HIE.It can not only effectively improve the neurological function of children,promote the repair and regeneration of nerve tissue,but also help to improve their developmental quotient and reduce the risk of sequelae such as mental retardation and cerebral palsy.It can play a good role in promoting the recovery and prognosis of children,and has high clinical application value.

关 键 词：亚低温治疗 单唾液酸四己糖神经节苷脂 新生儿缺氧缺血性脑病 神经功能 后遗症 价值 

分 类 号：R5[医药卫生—内科学]