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目的观察选择性头部亚低温联合促红细胞生成素治疗新生儿缺氧缺血性脑病的临床效果。方法将84例缺氧缺血性脑病随机分为观察组和对照组各42例,2组患儿均进行选择性头部亚低温治疗,在此基础上,观察组加用促红细胞生成素治疗。比较2组患者治疗后相关生化指标神经元特异性烯醇化酶(NSE)、S100B蛋白、白细胞(WBC)、基质金属蛋白酶-9(MMP-9)、尿酸(UA)、血管内皮生长因子(VEGF)水平和神经发育情况和预后。结果治疗前,NSE、S100B蛋白、WBC、MMP-9、UA和VEGF等水平在2组患儿之间均无明显差异(P>0.05)。治疗后,2组患儿的NSE、S100B蛋白、WBC、MMP-9、UA和VEGF等水平均较治疗前明显降低,差异均有统计学意义(P<0.05),且治疗后观察组上述指标均明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组大运动、精细运动、适应性、语言评分及总评分均高于对照组,差异均有统计学意义(P<0.05)。观察组出现脑瘫患儿的比例明显低于对照组,差异有统计学意义(P<0.05),但2组出现智力发育迟缓和死亡患儿的比例差异无统计学意义(P>0.05)。结论选择性头部亚低温联合促红细胞生成素治疗新生儿缺氧缺血性脑病可明显改善患儿的神经发育情况,两者联合可明显提高新生儿缺氧缺血性脑病治疗的疗效。
Objective To observe the clinical effect of selective head mild hypothermia combined with erythropoietin on neonatal hypoxic-ischemic encephalopathy. Methods Eighty-four patients with hypoxic-ischemic encephalopathy were randomly divided into observation group and control group, with 42 cases in each group. Both groups received selective head hypothermia. On the basis of this, the observation group was treated with erythropoietin . The biochemical indicators NSE, S100B, WBC, MMP-9, UA and VEGF in the two groups were compared after treatment. ) Level and neurodevelopmental status and prognosis. Results Before treatment, the levels of NSE, S100B protein, WBC, MMP-9, UA and VEGF had no significant difference between the two groups (P> 0.05). After treatment, the levels of NSE, S100B protein, WBC, MMP-9, UA and VEGF in two groups were significantly lower than those before treatment (all P <0.05), and the above indexes Were significantly lower than the control group, the difference was statistically significant (P <0.05). After treatment, the scores of large exercise, fine motor, adaptability, language score and total score in the observation group were higher than those in the control group, with significant differences (P <0.05). The proportion of children with cerebral palsy in the observation group was significantly lower than that in the control group (P <0.05), but there was no significant difference in the proportion of children with mental retardation and death in the two groups (P> 0.05). Conclusion Selective head mild hypothermia combined with erythropoietin in neonatal hypoxic-ischemic encephalopathy can significantly improve the neurological development in children with the combination of the two can significantly improve the therapeutic effect of neonatal hypoxic-ischemic encephalopathy.