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目的:观察纳洛酮联合丹参注射液治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法:将2011年6月至2012年10月大竹县妇幼保健院儿科收治的40例HIE患儿按随机数字表法分为对照组和观察组各20例。对照组给予吸氧、降颅压、温箱保暖、止惊、改善微循环及能量合剂等综合治疗,观察组在对照组治疗基础上联用纳洛酮和丹参注射液静脉滴注。观察患儿临床症状改善情况及治疗效果,定期随访,统计患儿后遗症的发生率。结果:观察组总有效率95.0%,高于对照组的65.0%(P<0.01);观察组器官功能损害及并发症发生率、预后不良率低于对照组(10.0%vs 55.0%、15.0%vs 40.0%,P均<0.01);观察组患儿神经反射、意识、肌张力恢复时间分别为(3.5±1.1)d、(3.2±1.0)d、(3.3±0.9)d,对照组分别为(5.7±1.0)d、(4.6±1.2)d、(5.5±1.4)d,两组比较差异均有统计学意义(P均<0.05);观察组治疗后中、重度HIE患儿NBNA评分高于对照组(P<0.05)。结论:纳洛酮联合丹参注射液治疗新生儿HIE疗效良好,值得临床推广应用。
Objective: To observe the curative effect of naloxone combined with Salvia miltiorrhiza injection on neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Forty HIE children admitted to Dazhu County Maternal and Child Health Hospital from June 2011 to October 2012 were divided into control group and observation group according to random number table. Control group was given oxygen, decreased intracranial pressure, warm incubator, only shock, improve microcirculation and energy mixture and other comprehensive treatment, the observation group in the control group based on the combination of naloxone and Salvia injection intravenous drip. Observe the improvement of clinical symptoms and treatment of children, regular follow-up, statistics of the incidence of sequelae in children. Results: The total effective rate in the observation group was 95.0%, which was higher than that in the control group (65.0%, P <0.01). The incidence of organ dysfunction and complication in the observation group was lower than that in the control group (10.0% vs 55.0%, 15.0% vs 40.0%, all P <0.01). The recovery time of neurological reflex, consciousness and muscle tone in the observation group were (3.5 ± 1.1) days, (3.2 ± 1.0) days and (3.3 ± 0.9) days, respectively (5.7 ± 1.0) days, (4.6 ± 1.2) days and (5.5 ± 1.4) days respectively. The differences between the two groups were statistically significant (all P <0.05). The NBNA score of the treatment group was significantly higher than that of the control group In the control group (P <0.05). Conclusion: Naloxone combined with Danshen injection in the treatment of neonatal HIE is effective and worthy of clinical application.