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目的探讨纳洛酮治疗新生儿缺氧缺血性脑病的疗效和安全性。方法近年收治的新生儿缺氧缺血性脑病患者50例,随机分为两组。对照组给予清除呼吸道分泌物、吸氧、镇静、控制惊厥和脑水肿、维持水电解质、酸碱平衡及预防感染等综合治疗;治疗组在常规综合治疗的基础上,加用纳洛酮,首次0.1 mg/kg静脉注射,随后以0.03~0.05mg/(kg.h)泵入,持续6 h,连用3~5d,或用到临床症状好转时停用。治疗期间监测患者临床症状、神经系统症状、体征,包括意识状态、四肢肌张力及原始反射。结果两组在临床症状体征消失、原始反射恢复方面差异均有统计学意义(P<0.01)。结论纳洛酮治疗新生儿缺氧缺血性脑病有一定的疗效,可促进临床症状改善,逆转脑损伤,促进受损神经功能恢复,阻断继发性脑损伤的发病过程,临床用药安全。
Objective To investigate the efficacy and safety of naloxone in the treatment of neonatal hypoxic-ischemic encephalopathy. Methods 50 cases of neonatal hypoxic ischemic encephalopathy admitted in recent years were randomly divided into two groups. The control group was given comprehensive treatment of removing respiratory secretions, oxygen, sedation, controlling seizures and brain edema, maintaining water and electrolyte, acid-base balance and preventing infection. On the basis of conventional comprehensive treatment, the treatment group added naloxone, 0.1 mg / kg intravenously, then pumped at 0.03 ~ 0.05mg / (kg.h) for 6 h, once every 3 ~ 5d, or used when clinical symptoms turn off. Patients were monitored for clinical symptoms, neurological symptoms, signs, including conscious status, limb muscle tension, and primary reflex during treatment. Results The clinical symptoms and signs disappeared in both groups, the original reflex recovery differences were statistically significant (P <0.01). Conclusion Naloxone treatment of neonatal hypoxic-ischemic encephalopathy have a certain effect, can improve clinical symptoms, reverse brain injury, promote recovery of damaged nerve function, block the pathogenesis of secondary brain injury, clinical drug safety.