硫酸镁治疗新生儿缺氧缺血性脑病的效果

Effect of magnesium sulfate on neonatal hypoxic-ischemic encephalopathy

目的探讨硫酸镁治疗新生儿缺氧缺血性脑病的效果。方法选取2018年2月至2019年8月于抚矿总医院妇产科出生的64例窒息新生儿作为研究对象,采用随机数字表法分为治疗组(32例)和对照组(32例)。对照组给予常规治疗,治疗组在对照组的基础上给予硫酸镁治疗。观察两组临床疗效、临床症状改善时间、Mg^(2+)水平、动脉血气pH、人S100B蛋白(S100-B)水平、患儿生长发育(Gesell评分)以及不良反应发生情况。结果治疗组总有效率为93.75%,高于对照组的71.88%,差异有统计学意义(P<0.05)。治疗组肌张力、原始反射和意识状态改善时间短于对照组,差异有统计学意义(P<0.05)。治疗前,两组动脉血气pH、Mg^(2+)水平和S100-B水平比较,差异无统计学意义(P>0.05);治疗后,治疗组2、6 d动脉血气pH、Mg^(2+)水平高于本组治疗前和对照组,S100-B水平低于本组治疗前和对照组,差异有统计学意义(P<0.05);治疗后,对照组6 d动脉血气pH、Mg^(2+)水平高于本组治疗前,S100-B蛋白水平低于本组治疗前,差异有统计学意义(P<0.05)。随访8个月后,治疗组Gesell评分高于对照组,差异有统计学意义(P<0.05)。治疗组出现低血压1例,对照组无不良反应,两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论硫酸镁可有效改善缺氧缺血性脑病新生儿临床症状,缩短病程,促进神经功能恢复,安全性高。

Objective To investigate the effect of magnesium sulfate in the treatment of neonatal hypoxic-ischemic encephalopathy.Methods A total of 64 asphyxia neonates born in the Department of Obstetrics and Gynecology of Fukuang General Hospital from February 2018 to August 2019 were selected as the research subjects.They were randomly divided into the treatment group(n=32)and the control group(n=32).The control group was given conventional treatment.The treatment group was additionally given magnesium sulfate treatment on the basis of the control group.The clinical efficacy,clinical symptoms improvement time,Mg^(2+)level,pH level of arterial blood gas and human S100-B protein(S100-B)level,the pediatric growth and development(Gesell developmental scale score),and the occurrence of adverse reactions of the two groups were observed.Results The total effectiveness rate of the treatment group was 93.75%,higher than that of 71.88%of the control group,with statistical significance(P<0.05).The improvement time of muscular tension,primitive reflex and state of consciousness in the treatment group was shorter than that of the control group,with statistical significance(P<0.05).The comparison of arterial blood gas pH,Mg^(2+)level,and S100-B level before treatment between the two groups of children was not statistically significant(P>0.05).The arterial blood gas pH and Mg^(2+)levels in the treatment group at 2 and 6 d after treatment were higher than those before treatment and the control group,and the level of S100-B was lower than that before treatment and the control group,with statistical significance(P<0.05).The arterial blood gas pH and Mg^(2+)of the control group at 6 d after treatment were higher than those before treatment,and the level of S100-B was lower than that before treatment,with statistical significances(P<0.05).After 8 months of follow-up,the Gesell score of the treatment group was higher than that of the control group,with statistical significance(P<0.05).One case of hypotension occurred in the treatment group,and the control group had no adverse reactions,total incidence of adverse reactions was compared between the two groups,the difference was not statistically significant(P>0.05).Conclusion Magnesium sulfate can effectively improve the clinical symptoms of neonates with hypoxic-ischemic encephalopathy,shorten the course of the disease,promote the recovery of nerve function in high safety.