摘要
目的探讨盐酸纳美芬联合亚低温疗法治疗新生儿缺氧缺血性脑病(HIE)的效果及对其脑电活动和预后的影响。方法对2016年7月至2018年7月徐州医科大学附属徐州市儿童医院收治的100例新生儿HIE的临床资料进行回顾性分析,按照治疗方法不同分为对照组和观察组,各50例。其中,对照组予以基础支持+亚低温疗法治疗,观察组予以基础支持+亚低温疗法+盐酸纳美芬治疗。比较两组新生儿的临床疗效、治疗后的脑电活动和治疗前后的血清学指标[神经元特异性烯醇化酶(NSE)、脑型肌酸激酶同工酶(CKBB)]变化、不良反应及预后。结果观察组总有效率高于对照组[88.0%(44/50)比70.0%(35/50)](P<0.05)。治疗后,观察组的电静息、爆发-抑制、低电压、弥漫性波、单一节律放电发生率均显著低于对照组(P<0.05)。治疗后,两组HIE新生儿的血清NSE、CKBB水平均下降(P<0.05),且观察组均低于对照组[(13.20±2.15)μg/L比(18.74±3.02)μg/L,(15.86±2.57)U/L比(24.62±4.36)U/L](P<0.05)。观察组总不良反应发生率为12.0%(6/50),对照组为8.0%(4/50),差异无统计学意义(P>0.05)。观察组总预后不良发生率低于对照组[6.0%(3/50)比32.0%(16/50)](P<0.05)。结论对新生儿HIE采用盐酸纳美芬联合亚低温疗法可显著改善脑电活动和血清学指标,疗效理想、安全可靠,且还可有效减少不良反应及降低预后不良发生率。
Objective To explore the effect of nalmefene hydrochloride combined with mild hypothermia in newborns with hypoxic-ischemic encephalopathy(HIE),and to analyze its influence on brain electrical activity and prognosis.Methods The clinical data of 100 cases of neonatal HIE admitted to Xuzhou Children′s Hospital Affiliated to Xuzhou Medical University from Jul.2016 to Jul.2018 were analyzed retrospectively.According to different treatment methods,they were divided into a control group and an observation group,50 cases each.The control group was given basic support+mild hypothermia therapy,while the observation group was given basic support+mild hypothermia therapy+nalmefene hydrochloride therapy.The clinical effect,brain electrical activity after treatment and changes of serological indicators[neuron-specific enolase(NSE),creatine kinase brain band isoenzyme(CKBB)]before and after treatment,adverse reactions and prognosis were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group[88.0%(44/50)vs 74.0%(37/50)](P<0.05).After treatment,the incidence rates of resting,burst-suppression,low voltage,diffuse wave and single-rhythm discharges in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of NSE and CKBB in both groups decreased(P<0.05),and the observation group were lower than the control group[(13.20±2.15)μg/L vs(18.74±3.02)μg/L,(15.86±2.57)U/L vs(24.62±4.36)U/L](P<0.05).The total adverse reaction incidence rate was 12.0%(6/50)in the observation group and 8.0%(4/50)in the control group,the difference was not statistically significant(P>0.05).The incidence of total poor prognosis rate in the observation group was significantly lower than that in the control group[6.0%(3/50)vs 32.0%(16/50)](P<0.05).Conclusion Nalmefene hydrochloride combined with mild hypothermia therapy for neonatal HIE can significantly improve brain electrical activity and serological indicators,with ideal efficacy,safety and reliability,and it can effectively reduce incidences of adverse reactions and poor prognosis.
作者
丁丽丽
王军
DING Lili;WANG Jun(Department of Neonatology,Xuzhou Children′s Hospital Affiliated to Xuzhou Medical University,Xuzhou 221008,China;Department of Neonatology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出处
《医学综述》
2019年第22期4589-4592,F0003,共5页
Medical Recapitulate
关键词
缺氧缺血性脑病
新生儿
盐酸纳美芬
亚低温疗法
脑电活动
预后
Hypoxic-ischemic encephalopathy
Newborns
Nalmefene hydrochloride
Mild hypothermia therapy
Brain electrical activity
Prognosis
