神经节苷脂联合亚低温治疗新生儿窒息并发缺氧缺血性脑病的疗效观察

Effect of ganglioside combined with mild hypothermia in treatment of asphyxia neonatorum with hypoxic ischemic encephalopathy

目的探究新生儿窒息并发缺氧缺血性脑病(HIE)行神经节苷脂联合亚低温治疗的效果。方法选取2014年2月至2016年10月南阳南石医院收治的新生儿窒息并发HIE患儿72例,按随机数表法分为对照组(36例,亚低温治疗)、研究组(36例,神经节苷脂联合亚低温治疗)。比较两组患儿临床疗效、血浆超氧化物歧化酶(SOD)、亚硝酸盐(NO_2^-)、血浆硝基酪氨酸(NT)水平、新生儿行为神经评分(NBNA)、不良反应及后遗症发生情况。结果研究组患儿临床治疗总有效率(97. 22%)高于对照组(72. 22%),差异有统计学意义(P <0. 05)。治疗后,研究组患儿SOD水平高于对照组,NO_2^-、NT水平低于对照组,NBNA评分高于对照组,差异有统计学意义(P <0. 05)。两组患儿治疗期间均无严重不良反应发生,治疗后随访12个月后遗症发生率比较,研究组(8. 33%)低于对照组(19. 44%),但差异无统计学意义(P> 0. 05)。结论神经节苷脂联合亚低温治疗可促进新生儿窒息并发HIE患儿行为神经功能的恢复,提高治疗效果。

Objective To explore the clinical effect of ganglioside combined with mild hypothermia on neonatal asphyxia complicated with hypoxic ischemic encephalopathy( HIE) in neonates. Methods Seventy-two cases of neonatal asphyxia complicated with HIE were selected from Feb 2014 to Oct 2016 in Nanyang Nanshi Hospital. According to the random number table method,they were divided into control group( 36 cases,mild hypothermia treatment) and study group( 36 cases,ganglioside combined with mild hypothermia treatment). The clinical efficacy,plasma superoxide dismutase( SOD),nitrite(NO2-),plasma nitrotyrosine( NT) level,neonatal behavioral neurological score( NBNA),adverse reactions and sequelae were all compared between two groups. Results The total effective rate of clinical treatment in study group( 97. 22%) was higher than that in control group( 72. 22%),and the difference was statistically significant( P < 0. 05). After treatment,the SOD level of study group was higher than that of control group,the NO2- and NT levels were lower than those of control group,and the NBNA score was higher thanthat of control group,and the differences were statistically significant( P < 0. 05). There were no serious adverse reactions in two groups during the treatment. The incidence of sequelae was 12 months after treatment. The study group( 8. 33%)was lower than the control group( 19. 44%),but the difference was not statistically significant( P > 0. 05). Conclusion Ganglioside combined with mild hypothermia therapy can significantly improve the behavioral neurological function of neonates with asphyxia complicated with HIE and improve the therapeutic effect.