还原型谷胱甘肽联合盐酸纳洛酮治疗新生儿缺氧缺血性脑病的效果观察

目的 探讨还原型谷胱甘肽联合注射用盐酸纳洛酮治疗新生儿缺氧缺血性脑病的临床效果。方法 选取2015年6月-2018年6月在安阳市中医院就诊的60例新生儿缺氧缺血性脑病患儿为研究对象，随机分为观察组（30例）和对照组（30例）。对照组给予患儿静脉滴注注射用盐酸纳洛酮0.02 mg/kg，1次/d。观察组在对照组基础上给予患儿还原型谷胱甘肽，20 mg加入20 mL 5%葡萄糖注射液中静脉滴注，1次/d。两组均治疗14 d。观察两组患者的临床疗效，对比两组临床症状消失时间、神经元特异性烯醇化酶（NSE）水平和新生儿行为神经测定（NBNA）评分以及不良反应发生情况。结果 与对照组总有效率73.33%比较，观察组总有效率96.67%显著升高（P<0.05）。治疗后，观察组肌张力、意识障碍和惊厥消失时间均显著短于对照组（P<0.05）。治疗后，两组NSE水平均较治疗前显著降低，NBNA评分均较治疗前显著升高（P<0.05）；治疗后，观察组NSE水平和NBNA评分改善显著优于对照组（P<0.05）。两组不良反应发生率分别为13.33%、6.67%，两组比较差异无统计学意义。结论 还原型谷胱甘肽联合注射用盐酸纳洛酮治疗新生儿缺氧缺血性脑病效果显著，值得临床推广。

Effect of reduced glutathione combined with naloxone hydrochloride in treatment of neonatal hypoxic ischemic encephalopathy

Objective To investigate the clinical effect of reduced glutathione combined with Naloxone Hydrochloride for Injection in treatment of neonatal hypoxic ischemic encephalopathy. Methods 60 cases of neonatal hypoxic ischemic encephalopathy in Anyang Hospital of Traditional Chinese Medicine from June 2015 to June 2018 were randomly divided into observation (30 cases) and control group (30 cases). Children in the control group iv administered with Naloxone Hydrochloride for Injection, 0.02 mg/kg, once daily. Children in the observation group were iv administered with reduced glutathione, 20 mg added into 5% Glucose Injection 20 mL, once daily. Children in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the disappearance time of clinical symptoms, NSE, NBNA score, and adverse reactions in two groups were compared. Results The total effective rate of observation group was 96.67%, which were higher than 73.33% of control group (P<0.05). After treatment, the time of muscle tension, disturbance of consciousness and convulsion disappeared in the observation group were significantly shorter than those in the control group (P<0.05). After treatment, the level of NSE in two group was significantly decreased, but the NBNA score was increased (P<0.05). After treatment, the changes of NSE and NBNA scores in the observation group were significantly better than those in the control group (P<0.05). The incidence of adverse reactions in two groups were 13.33% and 6.67%, there was no significant difference between two groups. Conclusion Reduced glutathione combined with Naloxone Hydrochloride for Injection in treatment of neonatal hypoxic ischemic encephalopathy has good effect, which is worthy of clinical promotion.