硫酸镁防治新生儿窒息合并症的疗效观察

Effects of magnesium sulphate on newborn asphyxia

探讨硫酸镁对新生儿窒息合并症的防治效果。方法 窒息新生儿 5 1例随机分为治疗组和对照组。对照组予常规治疗 ,治疗组在此基础上加用硫酸镁 ,首剂于出生 12h内予硫酸镁 2 5 0mg/kg ,首剂后 2 4及 48h各予维持量12 5mg/kg ,均溶于 10 %葡萄糖液中缓慢静脉泵入。监测指标包括 :生命体征、血气、血清乳酸脱氢酶 (LDH)、肌酸磷酸激酶 (CK)、肌酐 (Cr)、尿 β2 微球蛋白 ( β2 m)、头颅CT、脑干听觉诱发电位 (ABR) ,生后 6个月进行智测。结果 治疗组生后d1和d3PaO2 升高的差值高于对照组 (P <0 .0 5 ) ;治疗组生后d1和d7CK降低的差值大于对照组 (P <0 .0 5 ) ,两组LDH降低的差值差别不大 (P >0 .0 5 ) ;生后d1和d7血清Cr和尿 β2 m降低的差值 ,治疗组大于对照组 ,其中后者有非常显著的差异 (P <0 .0 5 ,P <0 .0 0 1) ;生后 6个月随访 2 8例 ,两组智力发育指数 (MDI)和运动发育指数(PDI)虽然治疗组略高于对照组 ,但无统计学意义。

Objective To investigate the effects of magnesium sulphate on newborn asphyxia. Methods 51 cases of neonatal infants with birth asphyxia were randomly divided into two groups. The infants in treated group (n=27) were given a leading dose of 250 mg/kg magnesium sulphate intravenously within 12 hours of delivery, followed by two further infusions of 125 mg/kg at 24 and 48 hours respectively. The infants in control group (n=24) were conventionally trea ted . Blood pressure, heart rate, breath rate, muscle tone, blood gas, serum LDH,CK, Cr, urine β 2m were measured in all infants. MDI and PDI were evaluated at 6 months of age. Results PaO 2 improved in treated infants in the first and third day of delivery was significantly better than those in control group(P<0.05). The decrease of serum CK in the former in the first and seventh day of delivery was significantly more than the latter (P<0.05). The decrease of serum Cr and urine β 2m in the former in the first and seventh day of delivery was significantly more than the latter (P<0.05;P<0.001). 28 cases of infants were followed up in 6 months of age and no significant differences of MDI and PDI were found between the two groups, so no significance statistically though the treated group was better than the controls. Conclusion Magnesium sulphate is effective in preventing and treating neonatal hypoxi-ischemic damage after birth asphyxia.