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目的:探讨对新生儿缺血缺氧性脑病(HIE)早期给予纳洛酮的干预治疗的疗效,及对HIE NBNA评分及预后的影响。方法:选择该院2007~2009年收治的64例中重度HIE患儿作为研究对象,全部患者根据入院先后顺序随机分为干预治疗组及对照组各32例,两组均给予吸氧、保暖、补液、纠正酸中毒、控制脑水肿、营养脑细胞等综合治疗,其中干预组在综合治疗的基础上加用纳洛酮0.01~0.03 mg/(kg.次)加入生理盐水5~10 ml静脉注射,意识清醒后按0.03~0.05 mg/(kg.h)持续静脉滴注3~5 h,1次/天,7~10天为1个疗程。观察比较两组的临床疗效及神经行为NBNA评分。结果:采用纳洛酮进行干预治疗的干预组的总有效率为85.71%(27/32),对照组总有效率为66.67%(22/32),两组总有效率比较,经统计学处理,差异有统计学意义(χ2=6.423,P<0.05)。干预组的临床症状包括呼吸改善时间、苏醒时间、惊厥消失时间均较对照组明显缩短,且干预组的临床体征全部消失时间也明显短于对照组,经统计学处理,差异均有统计学意义(P<0.05)。干预治疗1~3天后两组NBNA评分比较,经统计学处理,差异无统计学意义(P>0.05);干预治疗7~10天后两组NBNA评分比较,经统计学处理,差异有统计学意义(P<0.05)。干预组的存活率明显高于对照组,死亡率明显低于对照组,经统计学处理,差异有统计学意义(P<0.05)。结论:对于HIE,早期在综合治疗的基础上给予纳洛酮进行干预治疗,可以明显提高HIE患儿的临床疗效,有效地控制HIE患儿的临床症状及体征,明显提高NBNA评分,明显改善患儿的预后,提高了患儿预后的存活率,降低了死亡率,值得临床推广和应用。
Objective: To investigate the curative effect of intervention on naloxone in early neonates with hypoxic-ischemic encephalopathy (HIE) and its effect on the score and prognosis of HIE NBNA. Methods: Sixty-four patients with moderate and severe HIE admitted to our hospital from 2007 to 2009 were selected as study subjects. All patients were randomly divided into intervention group and control group according to the order of admission. All 32 patients were given oxygen, warm, Rehydration, acidosis correction, brain edema control, nutritional brain cells and other comprehensive treatment, in which the intervention group on the basis of comprehensive treatment plus naloxone 0.01 ~ 0.03 mg / (kg times) by adding saline 5 ~ 10 ml intravenously , Consciously 0.03 ~ 0.05 mg / (kg.h) by continuous intravenous infusion of 3 ~ 5 h, 1 time / day, 7 to 10 days for a course of treatment. The clinical efficacy and neurobehavioral NBNA score were compared between the two groups. Results: The total effective rate of the intervention group treated with naloxone was 85.71% (27/32), and the total effective rate of the control group was 66.67% (22/32). The total effective rate of the two groups was statistically significant , The difference was statistically significant (χ2 = 6.423, P <0.05). The clinical symptoms of the intervention group, including respiratory improvement time, recovery time, disappearance of convulsions were significantly shorter than the control group, and the intervention group all the clinical signs disappeared significantly shorter than the control group, the statistical analysis, the differences were statistically significant (P <0.05). NBNA scores of two groups after intervention for 1 ~ 3 days were statistically significant (P> 0.05), NBNA scores of two groups after intervention for 7 ~ 10 days were statistically significant (P <0.05). The survival rate of the intervention group was significantly higher than that of the control group, the mortality was significantly lower than that of the control group, the difference was statistically significant (P <0.05). Conclusion: For HIE, early treatment of naloxone on the basis of comprehensive treatment can significantly improve the clinical efficacy of HIE in children, effectively control the clinical symptoms and signs of HIE children, significantly improve NBNA score, significantly improved The prognosis of children, improve the survival rate of children with prognosis, reduce mortality, it is worth clinical promotion and application.