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目的 探讨苯巴妥对新生儿窒息和缺氧缺血性脑病 (HIE)的疗效及其合理用法。方法 :新生儿重度窒息伴 HIE患儿 37例 ,先给予苯巴比妥负荷量 2 0 mg/ kg,12小时后给予维持量 5 mg/ kg·日 ,共 7天。观察治疗效果和毒副作用 ,同时监测用药后 3小时、3天和 7天的药物血浓度。结果 :患儿意识、肌张力、反射等在 1～ 3天内恢复 ;脑水肿 3～ 7天内明显恢复 ;ABR于 4周大致正常 ,9～ 2 8天内痊愈出院 ;仅有一过性嗜睡 ,2～ 7天恢复正常 ,不影响新生儿神经行为评分。苯巴比妥用后 3小时即达有效稳态血浓度 ,3天、7天一直稳定在治疗范围。结论 :初步证实苯巴比妥负荷量治疗新生儿窒息和 HIE有一定疗效且无明显毒副作用。治疗药物监测对新生儿必要的
Objective To investigate the effect of phenobarbital on neonatal asphyxia and hypoxic-ischemic encephalopathy (HIE) and its rational use. Methods: Thirty-seven neonates with severe asphyxia accompanied by HIE were treated with phenobarbital at a dose of 20 mg / kg and maintenance dose of 5 mg / kg · d after 12 hours for 7 days. The therapeutic effect and side effects were observed. At the same time, the drug blood concentrations at 3, 3 and 7 days after drug administration were monitored. Results: Children’s consciousness, muscle tone, reflex and so on recovered within 1 to 3 days; brain edema recovered obviously within 3 to 7 days; ABR was generally normal within 4 weeks and recovered within 9 to 28 days; 7 days return to normal, does not affect the neonatal neurobehavioral score. Phenobarbital 3 hours after the effective steady-state blood concentration, 3 days, 7 days has been stable in the treatment range. Conclusion: The preliminary confirmation of phenobarbital load in the treatment of neonatal asphyxia and HIE have a certain effect and no obvious side effects. Therapeutic drug monitoring is necessary for newborns