目的 探討奧拉西坦聯(lián)合腦苷肌肽治療新生兒缺氧缺血性腦病的臨床療效。方法 選擇鄂東醫(yī)療集團(tuán)市婦幼保健院2015年7月-2017年2月收治的新生兒缺氧缺血性腦病患者110例，隨機(jī)分成對照組和治療組，每組各55例。對照組在常規(guī)治療的基礎(chǔ)上靜脈滴注腦苷肌肽注射液，2 mL加入5%葡萄糖注射液50 mL，1次/d。治療組在對照組的基礎(chǔ)上靜脈滴注奧拉西坦注射液，1 g加入5%葡萄糖注射液50 mL，1次/d。兩組患者均治療14 d。比較兩組患兒治療效果，新生兒神經(jīng)行為（NBNA）評分變化、患兒臨床體征改善時(shí)間、相關(guān)實(shí)驗(yàn)室檢查指標(biāo)水平以及不良反應(yīng)和后遺癥的發(fā)生情況。結(jié)果 治療后，對照組和治療組的臨床總有效率分別為78.18%和96.36%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療7、14 d后，兩組患者NBNA評分顯著升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組評分顯著高于同期對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組患者的呼吸、驚厥、意識障礙、原始反射異常和肌張力異常的改善時(shí)間均顯著早于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患兒的NSE、S-100蛋白和VEGF均顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組NSE、S-100蛋白和VEGF水平顯著低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組的恢復(fù)率為82.35%，顯著高于對照組（64.15%），兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 奧拉西坦聯(lián)合腦苷肌肽治療新生兒缺氧缺血性腦病臨床療效肯定，安全性好，具有一定的臨床推廣應(yīng)用價(jià)值。

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.