新生儿缺氧缺血性脑病83例的疗效观察

A clincal observation of therapeutic effect of ganglioside for 83 cases of neonatal hypoxic-ischemic encephalopathy

目的观察单唾液酸四己糖神经节苷脂对缺氧缺血性脑病的治疗效果。方法将西安市儿童医院收治的83例重度缺氧缺血性脑病患者随机分为两组，治疗组42例，对照组41例，两组均给以常规治疗，治疗组同时予以单唾液酸四己糖神经节苷脂治疗，10～14天为1个疗程。分别在3、7、14天进行新生儿行为神经测定。结果患儿两组3天行为神经测定评分（27．90±4．05，26．70±5．51）比较无统计学意义；治疗组7、14天行为神经测定评分（34．30±3．98，38．02±1．60）明显优于对照组（31．92±4．38，35．65±1．35），两组行为神经测定评分差异有显著性（分别为t7=2．59，P〈0．05和t14=7．26，P〈0．05）。结论单唾液酸四己糖神经节苷脂治疗新生儿中、重度缺氧缺血性脑病患儿疗效理想，多方位提供了神经保护作用，其不良反应罕见，安全范围大，值得临床推广。

Objective To observe therapeutic effect of monosialotetrahexosyl ganglioside for moderate and severe neonatal hypoxic-ischemic encephalopathy （HIE）. Methods 83 neonates with HIE treated in Department of Neonatology of Xi＇ an Municipal Children＇ s Hospital from September,2003 to March,2008 were divided into treatment group （n = 42） and control group （n = 41 ）. The neonates in both groups received conventional treatment and those in the treatment group received 20mg of ganglioside （intravenous drip, one time per day）for 10 - 14 days as well as conventional treatment. At day 3,7 and 14 after treatment, the neonates were evaluated with neonatal behavioral neurological assessment （NBNA）. Results At day 3, the score of NBNA of the neorates in the treatment group was 27.90 ± 4.05 and that in the control group was 26.70 ± 5.51, there was no significant difference between the two groups （ t = 1.12, P 〉 0.05 ）. The scores of NBNA of the neorates at day 7 and day 14 in the treatment group were 34.30 ± 3.98 and 38.02 ± 1.60 respectively and those in the control group were 31.92 ± 4.38 and 35.65 ± 1.35, there were significant differences between the two groups （ t = 2.59,7.26, respectively, P 〈 0.05）. Conclusion The therapeutic effect of monosialotetrahexosyl ganalioside for moderate and severe neonatal HIE is significant. The therapy is worthy to be popularized in clinic because of its rare adverse effects and broad safety range.