早期干预新生儿缺氧缺血性脑病临床研究.DOCVIP

临床医学论文-早期干预新生儿缺氧缺血性脑病临床研究 【关键词】? 新生儿；窒息；缺氧缺血性脑病；纳络酮；苯巴比妥；复方丹参注射液 　　【摘要】 目的?? 探讨纳络酮、苯巴比妥、复方丹参注射液联用早期干预新生儿缺氧缺血性脑病的临床效果。 方法?? 将68例重度窒息复苏后的新生儿随机分为观察组和对照组，每组各34例。对照组给予常规治疗，观察组在常规治疗的基础上加用纳络酮、苯巴比妥、复方丹参注射液，观察两组发生惊厥和重度缺氧缺血性脑病的情况及病死率。 结果?? 观察组惊厥、重度缺氧缺血性脑病及病死率明显低于对照组，差异有显著性（P＜0.05）；CT检查脑白质低密度分布范围观察组重度改变者明显低于对照组,差异有显著性（P＜0.05）。 结论?? 对重度窒息新生儿复苏后早期联合应用纳络酮、苯巴比妥、复方丹参注射液能有效预防新生儿惊厥及重度缺氧缺血性脑病的发生，降低病死率，改善预后。 　　【关键词】 新生儿；窒息；缺氧缺血性脑病；纳络酮；苯巴比妥；复方丹参注射液 　　Early intervention in newborns with hypoxieischemic encephalopathy 　　【Abstract】 Objective?? To explore curative effects of early intervention of combining naloxone, phenobarbital and Fufang Danshen injection in newborns with hypoxieischemic encephalopathy(HIE). Methods?? 68 newborns revived from severe asphyxia were randomly divided into observing and control group(each n=34). The control group was given routine treatment and the observing the combination of naloxone, phenobarbital and Fufang Danshen injection on the basis of routine treatment, observations were conducted for convulsion, status of severe HIE and fatality rate. Results牋 The convulsion, status of severe HIE and fatality rate were significantly lower in the observing than in the control group, difference was significant(P0.05); heavy changes of CT lowdensity distribution of brain white matter was significantly lower in the observing than in the control group and difference significant(P0.05). Conclusion牋 The early combination of naloxone, phenobarbital and Fufang Danshen injection in newborns revived from severe asphyxia can effectively prevent newborn convulsion and development of severe HIE, reduce fatality rate and improve prognosis. 　　【Keywords】 Newborn; asphyxia; HIE; naloxone;phenobarbital; Fufang Danshen injection 　　新生儿窒息所至缺氧缺血性脑病（HIE）是造成新生儿死亡和致残的主要原因之一。为探索一种有效的治疗方案，我院对重度窒息新生儿复苏后早期采用纳络酮、苯巴比妥、复方丹参注射液进行干预，取得满意疗效，现报告如下。 　　1 资料与方法 　　1 资料?? 病例选自2001年2月～2004年2月我院新生儿病房收治的68例重度窒息新生儿（出生后1min,Apgar评分≤3分），其中男40例，女28例，胎龄37～42w，出生体重2200～4750g。患儿有过度兴奋、嗜睡、惊厥、肌张力改变、原始反射减弱或消失及呼吸改变等。所有