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目的观察复方丹参注射液联合纳洛酮治疗新生儿缺氧缺血性脑病的临床疗效。方法 41例缺氧缺血性脑病患儿随机分为两组,对照组给予抗惊厥,维持血糖水平和改善血流灌注、营养支持、降颅压和改善脑水肿等常规治疗。治疗组在常规治疗的基础上给予纳洛酮和复方丹参注射液。观察两组患儿的临床疗效以及呼吸、意识状态、肌张力、原始反射恢复时间和惊厥控制时间。比较治疗前、治疗第10天患儿血液中白细胞介素(IL)-6、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α水平,并对患儿进行新生儿行为神经测定(NBNA)评分。结果治疗组总有效率较对照组有所提高,但差异无统计学意义(P>0.05)。治疗后,治疗组呼吸衰竭纠正时间、肌张力恢复时间、意识障碍恢复时间、原始反射恢复时间、惊厥控制时间明显低于对照组(P均<0.05)。IL-6、hs-CRP、TNF-α水平明显低于对照组(P均<0.05);治疗组治疗第14天和28天NBNA评分明显高于对照组(P均<0.05)。结论复方丹参注射液联合纳洛酮能较好地减轻机体炎症反应,改善机体神经功能,提高患儿生活质量。
Objective To observe the clinical efficacy of compound Danshen injection combined with naloxone in the treatment of neonatal hypoxic-ischemic encephalopathy. Methods Forty-one children with hypoxic-ischemic encephalopathy were randomly divided into two groups. The control group was given anticonvulsant, maintenance of blood glucose level, improvement of blood perfusion, nutrition support, reduction of intracranial pressure and improvement of cerebral edema. The treatment group was given naloxone and Fufang Danshen injection on the basis of routine treatment. The clinical efficacy and respiration, consciousness status, muscle tone, recovery time of primary reflex and time of seizure control were observed in both groups. The levels of IL-6, hs-CRP and TNF-α in the blood of the children before treatment and on the 10th day of treatment were compared, and their neonatal behavior Neurological assessment (NBNA) score. Results The total effective rate in the treatment group was higher than that in the control group, but the difference was not statistically significant (P> 0.05). After treatment, the treatment group respiratory failure corrective time, muscle tone recovery time, recovery time of consciousness, recovery time of original reflex, seizure control time was significantly lower than that of the control group (all P <0.05). The levels of IL-6, hs-CRP and TNF-α in the treatment group were significantly lower than those in the control group (all P <0.05). The NBNA scores on the 14th and 28th days in the treatment group were significantly higher than those in the control group (all P <0.05). Conclusion Compound Salvia injection combined with naloxone can reduce the body’s inflammatory response, improve the neurological function and improve the quality of life of children.