纳洛酮和苯巴比妥对新生儿缺氧缺血性脑病的干预作用

Early intervention in newborns with Naloxone and Phenobarbital in the treatment of neonatal hypoxic ischemic encephalopathy

目的新生儿缺氧缺血性脑病是导致儿童神经系统伤残的常见原因之一,且缺乏有效的治疗方法,本文将主要探讨纳络酮和苯巴比妥对新生儿缺氧缺血脑病的干预作用。方法选择2015-06至2017-06我院收治的新生儿缺氧缺血性脑病患儿160例,随机分成4组。4组患儿均给予对症支持治疗,观察A组加用纳络酮治疗,观察B组加用苯巴比妥治疗,观察C组加用纳络酮联合苯巴比妥治疗。4组患儿治疗后分别进行神经学评分和新生儿神经行为评定(Neonatal?behavioral?neurological?assessment,NBNA),同时记录反射时间和肌张力恢复时间。结果经治疗后,观察组有效率明显高于对照组,且观察C组的疗效最好,差异均有统计学意义(P<0.05);4组患儿神经学评分均有所升高,且观察组的神经学评分、反射恢复时间及肌张力恢复时间均低于对照组,差异有显著性(P<0.05);治疗后,观察组的NBNA评分高于对照组,差异均有统计学意义(P<0.05)。结论苯巴比妥和纳络酮可以改善新生儿缺氧缺血性脑病的预后情况,纳络酮联合苯巴比妥治疗可促进患儿神经功能恢复,有效提高治疗效果。

Objective：One of the common causes of children′s nervous system disability is hypoxic ischemic encephalopathy,in this paper,we will investigate the early intervention of naloxone and Phenobarbital in newborns with hypoxieischemic encephalopathy（HIE）. Methods：A total of 160 children with hypoxic ischemic encephalopathy were randomly divided into observing and control group（each n=40）and all of the children were received from our hospital from 2015-06 to 2017-06. The observing and control group were given routine treatment and the observing group A received naloxone,observing group B received phenobarbital,while observing group C received naloxone combined with phenobarbital. Neurological and neonatal neurobehavioral assessment was performed in these children and the time of reflection time and muscle tone recovery time was also recorded. Result The total efficacy rate in the observation group was significantly higher than that in the control group after treatment,and the best efficacy was observed in group C,difference was significant（P〈0.05）,after treatment,the neurological scores of the four groups were all increased,and the neurologic score,reflex recovery time and muscle tension recovery time of the observation group were lower than those in the control group and difference was significant（P〈0.05）. Conclusion：Phenobarbital and naloxone can improve the prognosis of neonatal hypoxic ischemic encephalopathy,The treatment of naloxone combined with phenobarbital can promote the recovery of nerve function in children and effectively improve the therapeutic effect.