苯巴比妥和纳洛酮联合治疗新生儿缺氧缺血性脑病疗效观察

Observation on the curative effect of phenobarbitone combined with naloxone in treatment of neonatal hypoxic-ischemic encephalopathy

目的:观察苯巴比妥联合纳洛酮治疗新生儿缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)的临床疗效。方法:将68例缺氧缺血性脑病患儿随机分为两组,对照组给予吸氧、控制惊厥、减轻脑水肿、维持电解质平衡等常规治疗,治疗组在常规治疗的基础上给予苯巴比妥4.5μg/(kg.min),同时加用盐酸纳洛酮0.1 mg/(kg.d),输液泵维持24 h持续经脉滴注,连用7天。观察两组患儿的临床疗效、意识恢复时间、反射恢复时间、肌肉张力的恢复时间以及不良反应。结果:治疗组与对照组的总有效率分别为88.24%(30/34)、76.47%(26/34),两组比较P<0.05;治疗后的意识恢复时间、反射恢复时间、肌肉张力的恢复时间治疗组均较对照组明显缩短(P<0.01)。结论:苯巴比妥可以降低HIE的发生率,与纳洛酮联用对预防HIE发生颅内出血及降低惊厥具有较好疗效,且安全性较高。

Objective：To observe the clinical efficacy of phenobarbitone combined with naloxone in treatment of neonatal hypoxic-ischemic encephalopathy（HIE）. Methods：Sixty-eight neonates with HIE were divided into two groups randomly,the neonates in control group were treated with routine therapies,including oxygen inhalation,controlling convulsions,relieving cerebral edema,and maintaining electrolyte balance;while the neonates in treatment group were treated with phenobarbitone（4.5 μg·kg-1·min-1） and naloxone hydrochloride（0.1 mg·kg-1·d-1） based on the therapies used in control group,continuous intravenous drip for seven days.The clinical efficacies,the recovery times of consciousness,the recovery times of muscular tension,and adverse reactions in the two groups were observed. Results：The total effective rates in treatment group and control group were 88.24%（30/34） and 76.47%（26/34）,respectively,there was significant difference between the two groups（P0.05）;the recovery times of consciousness,reflex,and muscular tension in treatment group were significantly shorter than those in control group（P0.01）. Conclusion：Phenobarbitone can reduce the incidence of HIE,phenobarbitone combined with naloxone has good curative effect for preventing intracranial hemorrhage and reducing the incidence of convulsions among the neonates with HIE,and the safety is high.