亚低温辅助苯巴比妥治疗新生儿窒息的效果及对患儿凝血功能的影响

Effect of mild hypothermia assisted with phenobarbital in the treatment of neonatal asphyxia and its influence on coagulation function in children

目的研究亚低温辅助苯巴比妥治疗新生儿窒息的效果及对患儿凝血功能的影响。方法选取2018年10月至2020年12月我院儿科收治的92例窒息新生儿为研究对象,随机将其分为对照组(46例,苯巴比妥治疗)和研究组(46例,亚低温辅助苯巴比妥治疗)。比较两组的治疗效果。结果治疗后,两组的神经元特异性烯醇化酶(NSE)、星形胶质源性蛋白(S100β)水平均明显降低,且研究组低于对照组(P<0.05)。研究组的临床治疗总有效率高于对照组(P<0.05)。治疗后,两组的凝血酶原时间(PT)、凝血酶时间(TT)明显缩短,肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)水平明显降低,且研究组优于对照组(P<0.05)。治疗后,两组的脑钠肽(BNP)水平、心脏Tei指数均下降,且研究组低于对照组(P<0.05)。研究组的住院时间、自主吮奶时间短于对照组,新生儿行为测定(NBNA)评分高于对照组(P<0.05)。结论亚低温辅助苯巴比妥治疗新生儿窒息的效果显著,可促进患儿病情改善,调节凝血功能,对心肌与脑组织损伤更小。

Objective To study the effect of mild hypothermia assisted with phenobarbital in the treatment of neonatal asphyxia and its influence on coagulation function in children.Methods A total of 92 cases of asphyxia neonates admitted in our hospital from October 2018 to December 2020 were selected as the research objects,and randomly divided into control group(46 cases,phenobarbital treatment)and study group(46 cases,mild hypothermia assisted with phenobarbital treatment).The therapeutic effects of the two groups were compared.Results After treatment,the levels of neuron-specific enolase(NSE)and astroglial-derived protein(S100β)in both groups significantly decreased,and those in the study group were lower than the control group(P<0.05).The total effective rate of clinical treatment of the study group was higher than that of the control group(P<0.05).After treatment,prothrombin time(PT)and thrombin time(TT)in both groups significantly shortened,while creatine kinase isoenzyme(CK-MB)and cardiac troponin T(cTnT)levels significantly decreased,and those in the study group were better than the control group(P<0.05).After treatment,the brain natriuriritic peptide(BNP)level and cardiac Tei index of both groups decreased,and those in the study group were lower than the control group(P<0.05).The hospital stay and self-sucking time in the study group were shorter than those in the control group,and the score of Neonatal Behavioral Neurological Assessment(NBNA)was higher than that in the control group(P<0.05).Conclusion The mild hypothermia assisted with phenobarbital in the treatment of neonatal asphyxia has a significant effect,which can promote the improvement of the state of an illness of the children,regulate the coagulation function,and reduce the damage to the myocardial and brain tissue.