硫酸镁治疗新生儿缺氧缺血性脑病的临床研究

Clinical study on salamarum in the treatment of neonatal hypoxic-ischemic encephalopathy

目的 探讨硫酸镁辅助治疗新生儿缺氧缺血性脑病 (HIE)的临床疗效。方法 6 2例中度HIE患儿随机分为治疗组和对照组。对照组 30例用常规治疗 ,治疗组 32例在常规治疗基础上入院后立即给予硫酸镁治疗 72小时 ,负荷量每天 2 0 0～ 2 5 0mg/kg ,维持量每天 1 2 5mg/kg。观察两组患儿神经系统症状消失时间 ,并于生后 7天 ,1 2～ 1 4天进行新生儿行为神经评分 (NBNA) ,6～ 1 2月进行发育商 (DQ)值测定。结果 治疗组凝视消失、意识恢复时间与对照组比较差异无显著性 ,惊厥停止、原始反射及肌张力恢复时间均短于对照组 ,差异有显著性(P <0 .0 5或 0 .0 1 )。治疗组生后 7天及 1 2～ 1 4天NBNA评分正常的例数多于对照组 ,其差异有显著性 (P <0 .0 5 ) ;治疗组患儿 6～ 1 2个月DQ值明显高于对照组 (91± 1 5vs 83± 1 5 ) (P <0 .0 5 )。结论 HIE在常规治疗基础上 ,早期应用硫酸镁治疗 ,能缩短神经系统症状消失时间 ,减少后遗症发生。

To study the potential therapeutic effect of Salamarum on neonatal hypoxic ischemic encephalopathy (HIE). Methods Sixty two neonates with moderate HIE were randomly assigned into two groups: a Control group (n=30) receiving conventional treatment and a Treatment group (n=32) receiving salamarum treatment, using loading dosage of 200-250 mg/kg and maintenance dosage of 125 mg/kg daily for 72 hrs after admission. The disappearance time of the nervous system symptoms, the neonatal behavioral neurological assessment (NBNA) scores and the development quotient (DQ) of Gesell Development Schedules for 6-12 months old infants were recorded. Results The time to cessation of gaze and the recovery time of consciousness in the Treatment group was not significantly different from that of the Control group. The time to cessation of convulsions and the recovery time of primitive reflexes and muscular tension were significantly shorter in the Treatment group. More neonates in the Treatment group had normal scores of NBNA than the Control group at 7 and at 12-14 days of life (P< 0.05 ). Moreover, the DQ values in the Treatment group were higher than the Control group at 6-12 months of life ( 91 ± 15 vs 83 ± 15 ) (P< 0.05 ). Conclusions Early salamarum administration can shorten the disappearance time of nervous system symptoms and reduce sequelae in neonates with HIE.