神经节苷脂和纳洛酮联合治疗新生儿缺氧缺血性脑病的效果及对NBNA评分的影响

Effect by ganglioside and naloxone in combined treatment of neonatal hypoxic-ischemic encephalopathy and their influence on NBNA score

目的探讨单唾液酸四己糖神经节苷脂钠注射液(简称神经节苷脂)和纳洛酮联合治疗新生儿缺氧缺血性脑病(HIE)的疗效及对新生儿行为神经测定(NBNA)评分的影响。方法 88例新生儿缺氧缺血性脑病患儿随机分为研究组与对照组,每组44例。在基础对症支持治疗基础上,对照组给予纳洛酮治疗,研究组给予纳洛酮联合神经节苷脂治疗,10 d为1个疗程,共治疗3个疗程,评价两组疗效并在每个疗程结束后记录NBNA评分。结果经过3个疗程的治疗,研究组临床治疗总有效率为88.64%,明显高于对照组的70.45%,差异具有统计学意义(P<0.05)。治疗1个疗程结束,两组NBNA评分比较差异无统计学意义(P>0.05);而在第2个疗程结束及第3个疗程结束时,研究组NBNA评分分别为(34.44±2.36)分、(37.42±2.39)分,显著高于对照组的(33.21±2.78)分、(35.01±2.46)分,差异具有统计学意义(P<0.05)。结论神经节苷脂和纳洛酮联合治疗新生儿缺氧缺血性脑病能够显著改善患儿的症状及体征,有助于NBNA评分改善,提高治疗疗效,适合推广使用。

Objective To investigate curative effect by monosialoteterahexosyl ganglioside sodium injection（ganglioside for short） and naloxone in combined treatment of neonatal hypoxic-ischemic encephalopathy（HIE） and their influence on neonatal behavioral neurological assessment（NBNA） score. Methods A total of 88 children patients with neonatal hypoxic-ischemic encephalopathy were randomly divided into research group and control group, with 44 cases in each group. On the basis of conventional symptomatic and supportive treatment, the control group received naloxone for treatment, and the research group received naloxone combined with ganglioside for treatment. 1 treatment course lasted for 10 d, and both groups received 3 treatment courses. Evaluation was made on curative effects in the two groups, and NBNA scores after each treatment course were recorded. Results After 3 treatment courses, the research group had obviously higher total effective rate in clinical treatment as 88.64% than 70.45% in the control group, and their difference had statistical significance（P〈0.05）. At the end of the first treatment course, there was no statistically significant difference of NBNA score between the two groups（P〉0.05）. At the end of the second and third treatment course, the research group had obviously higher NBNA scores as（34.44±2.36） and（37.42±2.39） points than（33.21±2.78） and（35.01±2.46） points in the control group, and their difference had statistical significance（P〈0.05）. Conclusion Combination of ganglioside and naloxone can remarkably improve symptoms and vital signs in children patients with neonatal hypoxic-ischemic encephalopathy. This method is helpful to improve NBNA score and enhance curative effect in treatment, and it is suitable for promotion and application.