大剂量白蛋白联合纳络酮治疗重度新生儿缺氧缺血性脑病疗效观察

目的探讨大剂量白蛋白联合纳络酮治疗重度新生儿缺氧缺血性脑病(HIE)的临床疗效。方法选择重度HIE患儿72例,分为3组:大剂量白蛋白与纳络酮(白蛋白 纳络酮)治疗组24例,给予静脉滴注人体白蛋白2 g/(kg.d),连续3~5 d,纳络酮0.1 mg/kg加10%葡萄糖20 ml,2 h滴完,每8 h 1次,连续3 d;大剂量白蛋白治疗组24例,静滴人体白蛋白2 g/(kg.d),连续3~5 d;对照治疗组24例。观察3组患儿临床症状体征变化,同时进行新生儿神经行为(NBNA)评分。结果大剂量白蛋白可显著提高重度HIE 2周后NBNA评分(P<0.05),与纳络酮联合治疗重度HIE,临床症状体征早期明显好转,NBNA评分进一步提高,与对照组相比差异显著(P<0.01)。结论大剂量白蛋白联合纳络酮治疗重度HIE疗效显著,预后改善。

Effect of Large Dose of Human Albumin and Naloxone on Newborns with Severe Hypoxic Ischemic Encephalopathy

Objective To study the effect of large dose of human albumin and naloxone on newborns with severe hypoxic ischemic encephalopathy(HIE).Methods Seventy two infants with severe HIE were divided into three groups: Albumin and naloxone treating group(n=24),treated with human albumin and naloxone for three days;albumin treating group(n=24),treated with human albumin only for 3 or 5 days;and control group(n=24). Changes of clinical symptoms and signs of all infants were observed,and the neonatal behavioral neurological assessment(NBNA) scores were evaluated.Results Compared with control group,large dose of human albumin could significantly improve the NBNA scores of severe HIE infants after two weeks(P<0.05),combination of large dose of human albumin and naloxone could early improve clinical symptoms and signs,and the NBNA scores were further increased(P<0.01).Conclusions Combination of large dose of human albumin and naloxone is effective on infants with severe HIE,and it can improve the prognosis of HIE.