神经节苷脂钠联合高压氧治疗对新生儿缺氧缺血性脑病的临床效果观察

摘要

Objective To observe the therapeutic effect of gangliosides and hyperbaric oxygen therapy on neonatal hypoxic ischemic encephalopathy. Methods Eighty patients with hypoxic ischemic encephalopathy admitted to our hospital from March 2009 to March 2012 were randomly divided into two groups with each group 40 cases. The treatment group was treated with conventional treatment combined with 20 mg gangliosides sodium and hyperbaric oxygen therapy one time a day, while the control group was only treated with conventional treatment for four weeks. The clinical performance, brain CT changes and neonatal behavioral neurological assessment ( NBNA ) three days, 14 days and 28 days after birth were observed and recorded, and then the therapeutic effect was compared and analyzed. Results 28 days after treatment, in the control group, 11 cases were significantly improved, 20 cases were improved and 9 cases were invalid; in the treatment group, 27 cases were significantly improved, 10 cases were improved and 3 cases were invalid. The difference in therapeutic effect between the two groups was statistically significant ( u = 4. 562, P < 0. 05 ) . The NBNA score three days after birth between the two groups showed no statistically significant difference ( t =0. 122, P >0. 05 ) . The NBNA score 14 days and 28 days after birth between the two groups both showed statistically significant differences ( t =3. 204, 4.530, P <0. 05) .Conclusion Gangliosides and hyperbaric oxygen treatment of neonatal hypoxic ischemic encephalopathy in early stage could significantly improve nervous system dysfunction and reduce complications , for which it should be recommended in neonates department.%目的 探讨神经节苷脂钠联合高压氧对新生儿缺氧缺血性脑病的临床治疗效果.方法 选取2009年3月-2012年3月我院新生儿缺氧缺血性脑病患儿80例为研究对象,按照随机数字表法将患儿分为治疗组和对照组,各40例,均采取常规的综合治疗措施,治疗组在此基础上加用单唾液酸四己糖神经节苷脂钠20 mg加入 10 %葡萄糖注射液50 ml中静脉滴注,1次/d;同时采用YLC 0.5/1型婴儿单人高压氧舱(广州船舶设计研究所制造) 给予高压氧治疗.评价两组治疗效果及出生后3 d(治疗前)、14 d及28 d行为神经测定(NBNA)评分.结果 治疗后28 d,对照组显效11例,有效20例,无效9例;治疗组显效27例,有效10例,无效3例;两组治疗效果比较,差异有统计学意义(u=4.562,P＜0.05).两组患儿出生后3 d NBNA评分比较,差异无统计学意义(t=0.122,P＞0.05);两组患儿出生后14 d、28 d NBNA评分比较,差异均有统计学意义(t值分别为3.204、4.530,P＜0.05).结论 新生儿缺氧缺血性脑病早期应用神经节苷脂钠联合高压氧治疗能显著改善神经系统功能障碍、减轻后遗症,值得在新生儿科中推广应用.