高压氧联合细胞生长肽治疗新生儿缺氧缺血性脑病64例临床分析
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[摘要] 目的 探讨高压氧联合细胞生长肽治疗新生儿缺氧缺血性脑病的临床效果。 方法 将我院收治的68例新生儿缺氧缺血性脑病患儿随机分为对照组和观察组，每组各34例。对照组采用高压氧治疗，观察组在对照组的基础上加用细胞生长肽治疗。分析两组的治疗效果及患儿智能发育情况。 结果 观察组总有效率显著优于对照组，差异有统计学意义（P ＜ 0.05）。观察组患儿智能发育情况优于对照组，差异有统计学意义（P ＜ 0.05）。 结论 采用高压氧联合细胞生长肽治疗新生儿缺氧缺血性脑病，疗效优于单用高压氧治疗，使用方便，值得临床推广应用。
[关键词] 高压氧；细胞生长肽；新生儿；缺氧缺血性脑病
[中图分类号] R722.1 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0024-02
Clinical analysis of hyperbaric oxygen combined with cell growth peptide in the treatment of 64 cases of newborns with hypoxic ischemic encephalopathy
HAO Yanqing
The First Hospital of Yulin City, Shaanxi Province, Yulin 719000, China
[Abstract] Objective To study the clinical effect of the hyperbaric oxygen combined with cell growth peptide in the treatment of newborns with hypoxic ischemic encephalopathy. Methods 68 cases of newborns with hypoxic ischemic encephalopathy were randomly divided into the control group and the observation group, each group had 34 cases. The control group was given hyperbaric oxygen therapy, the observation group was combined with cell growth peptide treatment on the basis of the control group. The treatment effect and newborns' intelligence development situation of the two groups were analyzed. Results The total effective rate of the observation group was significantly better than that of the control group, the difference was statistically significant (P < 0.05). The intelligence development situation in the observation group was better than that in the control group, the difference was statistically significant (P < 0.05). Conclusion The effect of hyperbaric oxygen combined with cell growth peptide in the treatment of newborns is better than hyperbaric oxygen therapy, which is easy to use, and it is worthy of application in clinic.
[Key words] Hyperbaric oxygen; Cell growth peptide; Newborns; Hypoxic ischemic encephalopathy
新生儿缺氧缺血性脑病（hypoxic ischemic encephalopahy of the newborn，HIE）是指由于围生期窒息、缺氧所引起的脑缺氧缺血性损害，临床以一系列神经系统异常为主要表现,多见于伴严重窒息的足月新生儿，可引起新生儿死亡，中重度幸存患儿多遗留神经系统损伤后遗症，严重影响患儿成长及生活质量[1]。高压氧是通过高于大气压下吸入纯氧，增加氧在机体组织血浆中的溶解度，从而改善微循环，恢复缺氧缺血脑细胞的正常能量代谢。细胞生长肽为重要的神经营养因子，在脑神经细胞损伤中可发挥修复与再生作用。本研究对我院2005年9月～2010年9月收治的68例新生儿缺氧缺血性脑病患儿，在高压氧疗的基础上给予细胞生长肽治疗，取得了良好效果，现报道如下：
1 资料与方法
1.1 一般资料
选择我院2005年9月～2010年9月收治的68例新生儿缺氧缺血性脑病患儿，男36例，女32例；日龄（1.5±0.5）d；患儿均有围生期缺氧、窒息史；Apgar评分5 min均＜5分，入院时间均不足24 h。参考CT及脑电图分度结果，其中，中度51例，重度17例。随机分为对照组和观察组，每组各34例。两组患儿性别、年龄、病情等一般情况比较，差异无统计学意义（P ＞ 0.05），具有可比性。见表1。
表1 两组一般情况比较
1.2 临床表现
患儿有意识障碍、惊厥、肌张力改变、过度兴奋或抑制等神经系统症状，意识障碍持续24 h以上。部分患者有前囟隆起，肌张力降低或严重低下，原始反射引出不全或未能引出等表现。少数患者可见明显的肢体抽动或眼球凝视。