目的 探討三磷酸胞苷二鈉聯(lián)合鼠神經(jīng)生長(zhǎng)因子治療新生兒缺氧缺血性腦病的臨床療效。方法 選擇2013年1月-2014年1月徐州市婦幼保健院新生兒科收治的缺氧缺血性腦病患兒80例,隨機(jī)分為對(duì)照組和治療組,每組各40例。對(duì)照組在基本治療的基礎(chǔ)上,在患兒出生后6 h內(nèi)肌肉注射注射用鼠神經(jīng)生長(zhǎng)因子,30μg/次,1次/d。治療組在對(duì)照組的治療基礎(chǔ)上靜脈滴注注射用三磷酸胞苷二鈉,100 mg/次加入到5%葡萄糖溶液30 mL中,1次/d。中度患兒治療14 d,重度患兒治療21 d。觀察兩組的臨床療效,同時(shí)比較兩組患兒癥狀與體征改善時(shí)間、行為神經(jīng)測(cè)試(NBNA)評(píng)分、智能發(fā)育量表(CDCC)測(cè)試結(jié)果。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為72.5%、92.5%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療組意識(shí)障礙恢復(fù)時(shí)間、驚厥停止時(shí)間、原始反射正常時(shí)間和肌張力正常時(shí)間均顯著短于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療后,兩組患兒行為能力評(píng)分、被動(dòng)肌張力評(píng)分、一般評(píng)估評(píng)分、總分均顯著升高,治療組主動(dòng)肌張力評(píng)分、原始反射評(píng)分顯著升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。兩組患兒出生后6、12個(gè)月CDCC檢測(cè)顯示治療組智能發(fā)育指數(shù)(MDI)、運(yùn)動(dòng)發(fā)育指數(shù)(PDI)均明顯高于對(duì)照組,兩組比較差異均具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。結(jié)論 三磷酸胞苷二鈉聯(lián)合鼠神經(jīng)生長(zhǎng)因子治療新生兒缺氧缺血性腦病具有較好的臨床療效,可改善患兒神經(jīng)功能和生存質(zhì)量,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical efficacy of cytidine disodium triphosphate combined with mouse nerve growth factor in treatment of neonatal hypoxic ischemic encephalopathy. Methods Patients (80 cases) with hypoxic ischemic encephalopathy in Department of Neonatology of Xuzhou Maternity and Child Health Hospital from January 2013 to January 2014 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in control group were im administered with Mouse Nerve Growth Factor for injection 6 h after birth on the basis of foundation treatment, 30 μg/time, once daily. The patients in treatment group were iv administered with Cytidine Disodium Triphosphate for injection on the basis of control group, 100 mg/time added into 5% glucose injection 30 mL, once daily. Children with moderate were treated for 14 d, and children with severe were treated for 21 d. After treatment, the efficacy was evaluated, and symptoms and signs improved time, NBNA scores, and CDCC test results in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 72.5% and 92.5%, respectively, and there were differences between two groups (P < 0.05). After treatment, consciousness disturbance recovery time, seizures stop time, primitive reflex normal time, and muscle tension normal time in the treatment group were shorter than those in the control group, and there were differences between two groups (P < 0.05). After treatment, behavior ability score, passive muscle tension score, general assessment score and total score in two groups were significantly increased, and active muscle tension score and primitive reflex score in the treatment group were significantly increased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). After birth of 6 and 12 months, MDI and PDI in treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Cytidine disodium triphosphate combined with mouse nerve growth factor has good clinical curative effect in treatment of neonatal hypoxic ischemic encephalopathy, and can improve neural function and life quality, which has certain clinical application value.