纳洛酮联合高压氧治疗新生儿缺氧缺血性脑病临床的研究.docVIP

纳洛酮联合高压氧治疗新生儿缺氧缺血性脑病临床的研究 　　[摘要] 目的:观察纳洛酮联合高压氧治疗新生儿缺氧缺血性脑病的疗效。方法:选择新生缺氧缺血性脑病患儿98例,随机分为两组。两组均采用常规治疗,治疗组同时静脉滴注纳洛酮和使用高压氧治疗。观察两组的临床疗效和新生儿神经行为评分(NBNA)变化。结果:治疗组和对照组的总有效率分别为92.0%和70.8%,两组比较,有显著性差异(P0.01);治疗组NBNA评分优于对照组(P0.05)。结论:纳洛酮联合高压氧治疗新生儿缺氧缺血性脑病效果显著。 　　[关键词] 缺氧缺血性脑病;新生儿;纳洛酮;高压氧 　　[中图分类号] R722.1[文献标识码]A [文章编号]1673-7210(2009)07(a)-105-02 　　 　　Clinical research of Naloxone joint Hyperbaric oxygen on treatment of neonatal hypoxic-ischemic encephalopathy 　　XU Biyong1, LAI Weiquan2 　　(1. Zijin Peoples Hospital, Zijin 517400, China; 2. Heyuan Peoples Hospital, Heyuan 517000, China ) 　　[Abstract] Objective: To observe the efficacy of Naloxone joint Hyperbaric oxygen on treatment of neonatal hypoxic-ischemic encephalopathy. Methods: 98 cases of neonatal hypoxic-ischemic encephalopathy were randomly divided into two groups. Both groups were treated using conventional treatment. The treatment group were intravenous injected of Naloxone and Hyperbaric oxygen at the same time. We observed the clinical treatment effect and NBNA score situation of two groups. Results: The total efficiency of the treatment group and the control group respectively were 92.0% and 70.8%, the difference was significant (P0.01). The treatment groups NBNA score was higher than that in the control group (P0.05). Conclusion: The effect of Naloxone joint hyperbaric oxygen on treatment of neonatal hypoxic-ischemic encephalopathy is remarkable. 　　[Key words] Hypoxic-ischemic encephalopathy; Neonatal; Naloxone; Hyperbaric oxygen 　　 　　新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)是由于围生期各种因素引起脑缺氧、缺血所导致的新生儿早期死亡及小儿智能发育障碍、脑性瘫痪和癫痫的脑损伤综合征,是造成儿童中枢神经系统损害最常见的原因之一。新生儿HIE发病中有10%～20%在新生儿期死亡,存活患儿中25%～30%可能留有远期神经发育后遗症,给家庭社会造成巨大负担,也使产科和儿科医师面临很大压力[1]。目前尚无特效疗法,致残率和死亡率极高。笔者应用纳洛酮联合高压氧治疗该病取得了良好的效果,现将结果报道如下: 　　1 资料与方法 　　1.1 一般资料 　　选择2008年1月～2008年12月在我科住院且符合HIE诊断依据及分度标准[2]的患儿98例,其中,中度38例,重度60例;均有产科复苏史和不同程度的神经系统异常表现,如易激惹、反应差、囟门紧张或饱满、瞳孔改变、四肢颤抖、肌张力改变、惊厥、呼吸暂停、昏迷等。随机分为治疗组和对照组两组。治疗组50例,男23例,女27例;早产儿11例,足月儿39例;体重4 000 g 5例;进行A