神经节苷脂和长春西汀在治疗早产儿缺氧缺血性脑病中作用.docVIP

神经节苷脂和长春西汀在治疗早产儿缺氧缺血性脑病中作用 　　[摘要] 目的 探讨早期应用神经节苷脂（GM-1）和恢复期联用长春西汀治疗早产儿缺氧缺血性脑病的临床疗效。方法 将110例确诊为早产儿缺氧缺血性脑病的患儿随机分为两组。Ⅰ组（对照组）54例，采用温箱保暖、面罩或鼻导管给氧、防制感染、稳定内环境、监测并维持血糖正常、维持血压、血气等治疗常规；Ⅱ组（治疗组）56 例，在常规治疗基础上早期加用GM-1 静脉注射，恢复期联用长春西汀治疗，并定期观察和随诊病情变化，进行统计学分析。 结果 治疗组治疗有效率优于对照组，差异有统计学意义（P 0.05）。结论 早期应用GM-1和恢复期联用长春西汀是治疗早产儿缺氧缺血性脑病并改善预后的有效方法之一， 有推荐意义。 　　[关键词] 早产儿；缺氧缺血性脑病 ；神经节苷脂；长春西汀 　　[中图分类号] R722.1 [文献标识码] B [文章编号] 1673-9701（2014）23-0114-03 　　[Abstract] Objective To investigate the clinical efficacy of the early application of gangliosidesand vinpocetine combined with during the recovery period in the treatment of premature infantswith hypoxic ischemic encephalopathy. Methods A total of 110 cases diagnosed as premature infants with hypoxic ischemic encephalopathy were divided into two groups. GroupⅠ（control group）54 cases used warm， oxygen inhalation， infection control， correction of acid-base and electrolyte disturbances， maintain normal blood glucose， blood pressure， blood gas and other conventional treatment；Group Ⅱ（treatment group） 56 cases on the basis of routine treatment combined with early intravenous GM-1， with vinpocetine in the recovery period， regular observation and follow-up condition changes were observed and made a statistical analysis. Results The effective rate of the treatment group was better than the control group. The difference was statistically significant（P 0.05）. Conclusion Early application of ganglioside and combination with vinpocetine in the recovery period is one of the effective methods to treat premature infants with hypoxic ischemic encephalopathy and improve prognosis， which is worth recommending. 　　[Key words] Premature infants； Hypoxic ischemic encephalopathy； Gangliosides（GM-1）；Vinpocetine 　　近年来，随着围产医学的发展，各地新生儿科建设的长足进步，使早产儿的存活率得到明显提高，但由于早产儿各系统尤其是脑的发育不成熟，且易发生围生期窒息，造成缺血缺氧和高碳酸血症，导致血压下降，脑血流减少，易并发缺氧缺血性脑病（HIE），成为引起早产儿死亡的主要原因，也使很多存活早产儿比足月儿更易出现神经发育障碍如运动障碍、癫痫发作和行为异常等。所以正确认识及积极对待早产儿HIE， 对减少脑瘫、认知以及行为学等后遗症的发生有重大意义。但是，目前早产儿HIE在专业文献中大多与足月儿HIE列在一起，以支持对症治疗为