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[摘要]
目的 分析促红细胞生成素联合纳洛酮治疗新生儿缺氧缺血性脑病的效果。方法 选择2015年1月—2018年1月西电集团医院收治的110例新生儿缺氧缺血性脑病患者,随机分为两组。对照组采用纳洛酮治疗,观察组采用促红细胞生成素联合纳洛酮治疗。两组均治疗14 d。比较两组的症状恢复时间,血清S100β蛋白和神经元特异性烯醇化酶(NSE)水平,并进行新生儿神经行为(NBNA)测定和随访后遗症发生情况。结果 观察组新生儿缺氧缺血性脑病的有效率(94.54%)明显高于对照组(76.36%),差异有统计学意义(P<0.05)。观察组的肌张力恢复时间、意识恢复时间和原始反射恢复时间均明显短于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清NSE和S100β蛋白水平明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且观察组的血清NSE和S100β蛋白水平明显低于对照组,差异有统计学意义(P<0.05)。两组治疗后3、7、14 d的NBNA评分均明显高于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);且观察组明显高于对照组,差异有统计学意义(P<0.05)。观察组后遗症发生率(3.64%)明显低于对照组(9.09%),差异有统计学意义(P<0.05)。结论 促红细胞生成素联合纳洛酮可以有效改善新生儿缺氧缺血性脑病的神经系统症状,降低血清S100β蛋白和NSE水平,减少后遗症的发生,提高疗效,值得应用推广。
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[Abstract]
Objective To investigate the efficacy of erythropoietin combined with naloxone in the treatment of neonatal hypoxic ischemic encephalopathy. Methods Selected 110 cases of patients with neonatal hypoxic ischemic encephalopathy who were treated in our hospital from January 2015 to January 2018, divided into two groups randomly. The control group was treated with naloxone, while the observation group was treated with erythropoietin combined with naloxone. Results The effective rate of the observation group was significantly higher than control group (P<0.05); the muscle tension, consciousness and primal reflex recovery time in the observation group were significantly shorter than control group (P<0.05); the serum S100β protein and NSE levels in the observation group were significantly lower than control group (P<0.05). The scores of NBNA at 3, 7 and 14 days after treatment in both groups were significantly higher than those before treatment (P<0.05), especially in the observation group (P<0.05); The incidence of sequela in the observation group was significantly lower than that control group (P<0.05). Conclusion Erythropoietin combined with naloxone can effectively improve the neurological symptoms of neonatal hypoxic-ischemic encephalopathy, reduce the levels of serum S100β protein and NSE, reduce the incidence of sequelae, improve the efficacy.
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