咖啡因联合神经节苷脂治疗呼吸衰竭脑损伤早产儿临床观察

Caffeine Citrate Combined with Ganglioside on Neurobehavior in Premature Infants with Respiratory Failure and Brain Injury

目的探讨咖啡因联合神经节苷脂治疗呼吸衰竭脑损伤早产儿的临床疗效及对患儿神经行为的影响。方法选取医院2017年8月至2019年8月收治的呼吸衰竭脑损伤早产儿86例,按接诊先后顺序随机分为观察组和对照组,各43例。两组患儿均予基础干预及枸橼酸咖啡因注射液静脉泵注,观察组患儿加用单唾液酸四己糖神经节苷脂静脉滴注,均连续治疗7 d。结果观察组总有效率为88.37%,明显高于对照组的69.77%(P<0.05);治疗后,观察组患儿新生儿神经行为(NBNA)量表、贝利婴儿发展量表各项目评分均明显高于对照组(P<0.05),神经烯醇化酶(NSE)、皮质醇(Cor)、肾上腺素(E)水平均明显低于对照组(P<0.05);观察组不良反应发生率与对照组相当(13.95%比9.30%,P>0.05)。结论咖啡因联合神经节苷脂治疗呼吸衰竭脑损伤早产儿,能改善患儿的神经行为、血清学指标及发育状态。

Objective To study the clinical efficacy of caffeine citrate combined with ganglioside on the neurobehaviour of premature infants with respiratory failure and brain injury.Methods A total of 86 premature infants with respiratory failure and brain injury admitted to the hospital from August 2017 to August 2019 were selected and randomly divided into the observation group and control group according to the sequence of admittance,43 cases in each group.Both groups were given basic treatment intervention and intravenous pump injection of caffeine citrate;on this basis,the observation group was added with intravenous drip of monosialic acid tetrahexose ganglioside.Both groups were continuously treated for 7 d.Results The total effective rate of the observation group was 88.37%,which was significantly higher than 69.77%of the control group(P<0.05).After treatment,the scores of items in the neonatal behavioral neurological assessment(NBNA)and Bayley Scales of Infant Development of the observation group were significantly higher than those of the control group(P<0.05);the levels of neuroenolase(NSE),cortisol(Cor)and epinephrine(E)were significantly lower than the control group(P<0.05);the incidence of adverse reactions in the observation group was comparable to the control group(13.95%vs.9.30%,P>0.05).Conclusion Caffeine citrate combined with ganglioside on premature infants with respiratory failure and brain injury can improve the neurobehavioral and serological indicators of the infants and improve their developmental status.