脑电图监测尼莫地平对新生儿缺氧缺血性脑病脑电活动的影响及疗效评价

目的:利用脑电图(EEG)监测作尼莫地平联合治疗新生儿缺氧缺血性脑病(HIE)的疗效评价.方法:选取50例HIE新生儿随机分为加用尼莫地平治疗组(尼莫地平组)25例和常规治疗组(对照组)25例,尼莫地平组在常规治疗的基础上加用尼莫地平;两组分别在出生后第3天和第15天进行EEG监测及新生儿行为神经能力测定(NBNA).结果:在出生后第3天,两组EEG异常率无差异,但在第15天,尼莫地平组的中、重度HIE新生儿的EEG异常率显著低于对照组(P＜0.05),功率谱峰值显著高于对照组(P＜0.05),EEG表现为惊厥性放电平均波幅降低,放电持续时间缩短,放电数量减少;临床表现为惊厥发作次数减少(P＜0.05);NBNA评分正常率高于对照组(P＜0.05);意识、反射和肌张力的恢复时间均明显短于对照组(P＜0.05).结论:尼莫地平联合应用治疗新生儿HIE在一定程度上能达到保护神经元的作用,对中、重度HIE患儿疗效明显.

Detecting and evaluating the effect of nimodipine on neonates with hypoxic-ischemic encephalopathy by electroencephalography

Objective:To detect and evaluate the effect of nimodipine on newborns with hypoxic-ischemic encephalopathy(HIE)by electroencephalography(EEG).Methods:Fifty newborns with HIE were selected and randomly divided into 2 groups:the nimodipine group(n=25)and the control group(n=25).Conventional therapy was used in both groups.Nimodipine treatment was added to the nimodipine group.EEG and neonatal behavior and nervous assay(NBNA)of the neonates were performed on the 3rd and 15th day.Results:EEG abnormality rates of moderate and severe HIE neonates in the nimodipine group were significantly lower than those in the control group on the 15th day(P<0.05).Peak of power spectrum in the nimodipine group was significantly higher than those in the control group on 15th day(P<0.05).Average amplitude,duration and quantity of convulsibility discharge in EEG or clinical convulsion attack in the nimodipine during group treatment were significantly lower than in the control on the 15th day(P<0.05).Normal rates of score of neonatal behavior and nervous assay in the Nimodipine group were significantly higher than those in the control on the 15th day(P<0.05).Recovery of consciousness,reflex and muscular tension in the nimodipine group were significantly shorter than those in the control on the 15th day(P<0.05).Conclusions:Nimodipine therapeutic alliance can protect neuron of newborns with HIE by preventing calcium 2 from inflowing,therefore it can produce conspicuous therapeutic effect on moderate and severe patients with HIE.