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目的研究参附注射液对新生儿重度窒息复苏后多脏器功能的保护作用。方法选取2012年5月-2015年4月临床收治的58例重度窒息新生儿,根据抽签法分为观察组和对照组,每组29例。对照组给予常规治疗方案加以20 ml浓度为5%的葡萄糖溶液进行治疗,观察组采取常规治疗联合20 ml浓度为5%的葡萄糖溶液和1 ml/kg的参附注射液稀释后进行治疗。比较两组患儿入院时和治疗后7 d的氧合指数及生化指标[血清神经元特异性烯醇化酶(NSE)、肌酐(Cr)、天冬氨酸氨基转移酶(AST)、血清丙氨酸氨基转移酶(ALT)、血清肌酸激酶同工酶(CK-MB)],分析两组患儿神经行为评分和死亡率。结果观察组患儿的氧合指数显著高于对照组[(374.31±30.45)比(287.32±25.32)],NSE、Cr、AST、ALT、CK-MB生化指标显著低于对照组[(25.43±2.56)pg/ml比(34.32±3.53)pg/ml,(103.54±10.43)μmol/L比(153.21±12.43)μmol/L,(135.32±11.32)U/L比(186.43±14.34)U/L,(94.21±8.32)U/L比(125.32±15.32)U/L,(147.54±13.21)U/L比(235.43±19.43)U/L],组间比较差异均有统计学意义(P<0.05)。治疗后15d、30d,观察组患儿的神经行为评分显著高于对照组[(30.42±1.87)分比(25.32±1.43)分,(36.43±1.03)分比(31.04±1.35)分],差异均有统计学意义(P<0.05)。结论参附注射液能保护新生儿重度窒息复苏后多脏器功能,降低重要脏器缺血缺氧—再灌注受损程度,有利于神经行为的改善,提高患儿的生存率。
Objective To study the protective effect of Shenfu Injection on multiple organ function after neonatal severe asphyxia resuscitation. Methods Fifty-eight neonates with severe asphyxia were selected from May 2012 to April 2015, and divided into observation group and control group according to the drawing method, with 29 cases in each group. The control group was treated with 20 ml of 5% dextrose solution. The observation group was treated with 20 ml dextrose solution with 5% dextrose and 1 ml / kg Shenfu injection. The oxygenation index and biochemical indexes at admission and after 7 days of treatment were compared between two groups [serum neuron specific enolase (NSE), creatinine (Cr), aspartate aminotransferase (AST), serum C ALT, CK-MB), neurobehavioral scores and mortality were compared between the two groups. Results The oxygenation index of the observation group was significantly higher than that of the control group [(374.31 ± 30.45) vs (287.32 ± 25.32)], and the biochemical indexes of NSE, Cr, AST, ALT and CK- 2.56) pg / ml (34.32 ± 3.53) pg / ml, (103.54 ± 10.43) μmol / L vs 153.21 ± 12.43 μmol / L, 135.32 ± 11.32 U / L vs 186.43 ± 14.34 U / L , (94.21 ± 8.32) U / L ratio (125.32 ± 15.32) U / L, (147.54 ± 13.21) U / L ratio (235.43 ± 19.43) U / L] .The differences between the two groups were statistically significant (P < 0.05). The neurobehavioral scores in the observation group were significantly higher than those in the control group [(30.42 ± 1.87) vs (25.32 ± 1.43) vs (36.43 ± 1.03) vs (31.04 ± 1.35)] on the 15th and 30th day after treatment, respectively All were statistically significant (P <0.05). Conclusion Shenfu injection can protect multiple organ function after neonatal severe asphyxia and reduce the degree of hypoxia-reperfusion injury in vital organs, which is beneficial to improve neurological behavior and improve the survival rate of children.