目的 評價(jià)神經(jīng)節(jié)苷脂聯(lián)用納洛酮治療新生兒缺氧缺血性腦?。℉IE）的有效性和安全性。方法 計(jì)算機(jī)檢索PubMed、EMBASE、Cochrane圖書館、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫（Wanfang Database），檢索時(shí)間均從建庫至2019年3月，納入有關(guān)神經(jīng)節(jié)苷脂聯(lián)用納洛酮治療HIE的隨機(jī)對照試驗(yàn)（RCT），采用RevMan 5.3軟件進(jìn)行統(tǒng)計(jì)學(xué)處理。結(jié)果 共納入15篇RCTs，1 116例患兒。Meta-分析顯示：與對照組比較，試驗(yàn)組的臨床有效率顯著提高（RR=1.25，95% CI=1.18～1.33，P<0.01）、NBNA評分顯著改善（MD=4.24，95% CI=3.72～4.76，P<0.01）、意識恢復(fù)時(shí)間顯著減少（MD=-2.13，95% CI=-2.54～-1.71，P<0.01）、反射恢復(fù)時(shí)間顯著減少（MD=-2.14，95% CI=-3.31～-1.56，P<0.01）和肌張力恢復(fù)時(shí)間顯著減少（MD=-2.46，95% CI=-3.99～-1.13，P<0.01）、隨訪后遺癥發(fā)生率顯著減少（RR=0.23，95% CI=0.11～0.46，P<0.01）；按照對照組干預(yù)措施不同采用亞組分析結(jié)果基本一致。結(jié)論 神經(jīng)節(jié)苷脂聯(lián)用納洛酮治療新生兒HIE科有效改善NBNA評分，縮短臨床體征恢復(fù)時(shí)間，減少后遺癥的發(fā)生。

Objective To evaluate the efficacy and safety of ganglioside combined with naloxone in the treatment of neonatal with hypoxic ischemic encephalopathy (HIE). Methods The randomized controlled trials(RCT) related to ganglioside combined with naloxone in the treatment of HIE were electronically searched PubMed,EMBASE,Cochrane library, CBM, CNKI, VIP and Wanfang Database form establishement to March 2019. Meta-analysis was performed by RevMan 5.3. Results Fifteen RCTs involving 1 116 infants with HIE were included. Meta-analyses showed that, compared with the control group, the treatment group of the effective rate was higher (RR=1.25, 95%CI=1.18-1.33, P<0.01), the NBNA mark was improved (MD=4.24, 95%CI=3.72-4.76, P<0.01), conscious recovery time was reduced (MD=-2.13, 95%CI=-2.54--1.71, P<0.01), the reflex recovery time was reduced (MD=-2.14, 95%CI=-3.31--1.56, P<0.01) and the muscle tension recovery time was reduced (MD=-2.46, 95%CI=-3.99--1.13, P<0.01) and with lower occurrence rate of sequelae of nerve system (RR=0.23, 95%CI=0.11-0.46, P<0.01). Subgroup analysis results were basically consistent according to different interventions in the control group. Conclusion Ganglioside combined with naloxone in the treatment of neonatal with HIE can effectively improve NBNA score, shorten the recovery time of clinical signs and reduce the occurrence of sequelae.