纳洛酮联合丹参注射液治疗新生儿缺氧缺血性脑病疗效观察

Effect of Naloxone Combined with Salvia Injection on Neonatal Hypoxic Ischemic Encephalopathy

目的:观察纳洛酮联合丹参注射液治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法:将2011年6月至2012年10月大竹县妇幼保健院儿科收治的40例HIE患儿按随机数字表法分为对照组和观察组各20例。对照组给予吸氧、降颅压、温箱保暖、止惊、改善微循环及能量合剂等综合治疗,观察组在对照组治疗基础上联用纳洛酮和丹参注射液静脉滴注。观察患儿临床症状改善情况及治疗效果,定期随访,统计患儿后遗症的发生率。结果:观察组总有效率95.0%,高于对照组的65.0%(P<0.01);观察组器官功能损害及并发症发生率、预后不良率低于对照组(10.0%vs 55.0%、15.0%vs 40.0%,P均<0.01);观察组患儿神经反射、意识、肌张力恢复时间分别为(3.5±1.1)d、(3.2±1.0)d、(3.3±0.9)d,对照组分别为(5.7±1.0)d、(4.6±1.2)d、(5.5±1.4)d,两组比较差异均有统计学意义(P均<0.05);观察组治疗后中、重度HIE患儿NBNA评分高于对照组(P<0.05)。结论:纳洛酮联合丹参注射液治疗新生儿HIE疗效良好,值得临床推广应用。

Objective： To observe the clinical curative effect of combined therapy of naloxone and Salvia injection on hypoxic ischemic encephalopathy （HIE） in newborns. Methods： Forty cases of newborns with HIE selected from June 2011 to October 2012 in pediatrics of our hospital were divided into an observation group （ n = 20） and a control group （ n = 20）. The control group received conventional treatments including oxygen therapy, intracranial pressure reduction, keeping warm in an incubator, anti-convulsion, improving microcirculation and energy supply. Additionally, the observation group was treated with naloxone and Salvia injection intravenously on bases of conventional treatments. Clinical symptoms were observed during treatment. The incidence of sequela was observed through regular follow-up. Results： The total effective rate in the treatment group was higher than that in the control group （95.0% vs 65.0%, P〈0.01 ）. The incidence of organ dysfunction and complications, rate of poor prognosis in the observation group were significantly lower than those in the control group （ P〈0. 01 ）. The recovery time of primitive reflex, consciousness and muscle tension in the observation group were shorter than those in the control group [ （3.5±1.1） d vs （5.7±1.0） d, （3.2±1.0） d vs （4.6±1.2） d, and （3.3±0.9） d vs （5.5± 1.4） d, respectively （P〈0.05）. The NBNA scores of the children with moderate and severe HIE in the observation group were significantly higher than those in the control group （P〈0.05）. Conclusions： Naloxone combined with Salvia injection for neonate with HIE are effective and worthy of clinical application.