奥拉西坦联合脑苷肌肽治疗新生儿缺氧缺血性脑病的临床研究

目的探讨奥拉西坦联合脑苷肌肽治疗新生儿缺氧缺血性脑病的临床疗效。方法选择鄂东医疗集团市妇幼保健院2015年7月—2017年2月收治的新生儿缺氧缺血性脑病患者110例,随机分成对照组和治疗组,每组各55例。对照组在常规治疗的基础上静脉滴注脑苷肌肽注射液,2 mL加入5%葡萄糖注射液50 mL,1次/d。治疗组在对照组的基础上静脉滴注奥拉西坦注射液,1 g加入5%葡萄糖注射液50 mL,1次/d。两组患者均治疗14 d。比较两组患儿治疗效果,新生儿神经行为(NBNA)评分变化、患儿临床体征改善时间、相关实验室检查指标水平以及不良反应和后遗症的发生情况。结果治疗后,对照组和治疗组的临床总有效率分别为78.18%和96.36%,两组比较差异具有统计学意义(P0.05)。治疗7、14 d后,两组患者NBNA评分显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组评分显著高于同期对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者的呼吸、惊厥、意识障碍、原始反射异常和肌张力异常的改善时间均显著早于对照组,两组比较差异具有统计学意义(P0.05)。两组患儿的NSE、S-100蛋白和VEGF均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组NSE、S-100蛋白和VEGF水平显著低于对照组,两组比较差异具有统计学意义(P0.05)。治疗组的恢复率为82.35%,显著高于对照组(64.15%),两组比较差异具有统计学意义(P0.05)。结论奥拉西坦联合脑苷肌肽治疗新生儿缺氧缺血性脑病临床疗效肯定,安全性好,具有一定的临床推广应用价值。

Clinical study on oxiracetam combined with cattle encephalon glycoside and ignotin in treatment of neonatal hypoxic ischemic encephalopathy

Objective To explore the clinical effect of oxiracetam combined with cattle encephalon glycoside and ignotin in treatment of neonatal hypoxic ischemic encephalopathy (HIE). Methods Patients (110 cases) with HIE in Huangshi Maternal and Child Health-Care Hospital from July 2015 to February 2017 were randomly divided into control and treatment groups. Each group had 55 cases. Patients in the control group were iv administered with Cattle Encephalon Glycoside and Ignotin Injection on the basis of conventional therapy, 2 mL added into 5% glucose injection 50 mL, once daily. Patients in the treatment group were iv administered with Oxiracetam Injection on the basis of control group, 1 g added into 5% glucose injection 50 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy were evaluated, neonatal behavioral neurological assessment (NBNA) scores, improvement time of clinical signs, related laboratory examination index levels, adverse reactions, and sequela in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 78.18% and 96.36%, respectively, and there were differences between two groups (P < 0.05). After treatment for 7 and 14 d, NBNA scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And NBNA scores in the treatment group were better than those in the control group in the same period (P < 0.05). After treatment, the improvement time of respiration, convulsions, disturbance of consciousness, primitive reflex anomaly, and dystonia were shorter than those in the control group, and there were significant differences between two groups (P < 0.05). NSE, S-100 protein, and VEGF were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And those levels in the treatment group were better than those in the control group (P < 0.05). The recovery rate in the treatment group was 82.35%, significantly higher than that in the control group (64.15%), and there were differences between two groups (P < 0.05). Conclusion Oxiracetam combined with cattle encephalon glycoside and ignotin has good effect in treatment of HIE with good safety, which has a certain clinical application value.