亚低温联合神经节苷脂治疗中重度新生儿脑损伤的影响

Effect of Mild Hypothermia Combined with Ganglioside on Moderate and Severe Neonatal Brain Injury

目的:分析亚低温联合神经节苷脂治疗中重度新生儿脑损伤的影响。方法:选择2018年6月至2020年6月漳州市第二医院产科86例重度脑损伤新生儿,并按照随机数字排列法分为观察组和对照组患儿,各43例,对照组患儿采用常规治疗并心电监护的基础上,给予神经节苷脂治疗;观察组在对照组基础上,加以亚低温治疗,比较两组患儿治疗后的新生儿20项行为神经评分法(neonatal behavioral neurological assessment,NBNA)评分、临床疗效、肌张力、反射、意识恢复时间以及后遗症并发情况。结果:经过治疗后,两组患儿第三、第七及第十四天的NBNA评分均有所上升,且观察组患儿治疗后的NBNA评分均明显高于治疗前、对照组患儿(P<0.05);观察组患儿治疗后总有效率95.35%明显高于对照组患儿总有效率81.39%(P<0.05);观察组患儿肌张力、反射、意识恢复时间均明显低于对照组患儿(P<0.05);观察组患儿干预治疗后出现脑瘫、智力低下、癫痫等后遗症情况显著低于对照组患儿(P<0.05)。结论:采用亚低温联合神经节苷脂能够有效治疗中重度新生儿脑损伤,改善患儿NBNA评分,减少肌张力、反射、意识恢复时间,并降低后遗症发生率,临床效果较好,具有较高的临床应用价值。

Objective:To analyze the effect of mild hypothermia combined with ganglioside on moderate and severe neonatal brain injury.Methods:From June 2018 to June 2020,86 newborns with severe brain injury in Zhangzhou Second hospital were randomly divided into observation group and control group,43 cases in each group.The control group was given ganglioside treatment on the basis of routine treatment and ECG monitoring;the observation group was given mild hypothermia treatment on the basis of the control group,and the neurobehavioral tests of the two groups were compared NBNA score,clinical efficacy,muscle tension,reflex,recovery time of consciousness and complications of sequelae.Results:After treatment,the NBNA scores on the third,seventh and fourteenth days of the two groups were increased,and the NBNA scores of the observation group after treatment were significantly higher than those before treatment and the control group(P<0.05);the total effective rate of the observation group was 95.35%,which was significantly higher than that of the control group(81.39%)(P<0.05);the recovery time of muscle tension,reflex and consciousness in the observation group was significantly higher than that in the control group(P<0.05)The incidence of cerebral palsy,mental retardation,epilepsy and other sequelae in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Mild hypothermia combined with ganglioside can effectively treat moderate and severe neonatal brain injury,improve NBNA score,reduce muscle tension,reflex,consciousness recovery time,and reduce the incidence of sequelae.The clinical effect is good and has high clinical application value.