不同剂量纳洛酮与方法治疗新生儿缺氧缺血性脑病的比较(附63例病例分析)

Analysis on Treatment of Neonate Suffered from HIE with Two Different Usage of Naloxone

目的 通过前瞻性双盲对照研究 ,了解 2种不同剂量纳洛酮方法对新生儿缺氧缺血性脑病 (HIE)的疗效情况和安全性。方法 将 2 0 0 1- 0 6～ 2 0 0 2 - 0 6收治的中重度HIE患儿随机分为 2组 :实验组给予纳洛酮首剂为 0 0 5～ 0 1mg/kg ,静脉注射 ,随后改为 0 0 3～ 0 0 5mg/(kg .h)静脉泵入 ,持续 6h ,连用 3d ;对照组给予纳洛酮 0 4mg/次静滴 ,1h内进入 ,连用 3d。于用药后不同时间内测定血压、心率、血糖 ;并记录呼吸暂停、心律失常的出现时间和次数。结果 对照组于用药后 30、6 0、12 0min所测的血压、心率和血糖均明显高于治疗组 ,具有高度显著性差异 (P <0 0 1) ;2组相比总的呼吸暂停次数和用药 4h后呼吸暂停次数具有显著性差异 ;对照组有 1例出现明显的心律不齐 ,1例出现交界性早博 ,停用纳洛酮后消失 ;治疗组无心律失常发生。治疗组与对照组相比较有效率无明显差异 (χ2 =0 0 89,P >0 0 5 ) ,但显著效率具有显著性差异 (χ2=4 5 2 ,P <0 0 5 )。

Objective To discuss the curative effect and safety of two different usage of naloxone on the treatment of neonate suffered from HIE. Methods The moderate and severe cases of neonates suffered from HIE from June 2001 to June 2002 were divided into test group and control group. The naloxone was given 0.05～0.1mg/kg i.v. in first dose and then 0.03～0.05mg/kg pumped in intravenously 6h for 3 days in test group. The naloxone was given 0.4mg/kg within 1h for 3 days. The Bp, HR and blood glucose were detected and the time and frequency of respiratory pause and rhythm were recorded. Results The Bp, HR and blood glucoe in test group were higher than control group and there was obviously significant difference (P<0.01). There was significant difference between two groups in respiratory pause and heart rhythm. Conclusion The method of test group was more safe than control group.