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目的探讨低剂量纳洛酮治疗新生儿窒息的临床疗效。方法选取黄冈市妇幼保健院2014年5月—2015年11月收治的窒息新生儿90例,随机将患儿分为低剂量组与对照组,各45例。选取本院2015年12月—2016年12月收治的窒息新生儿60例。随机分为5组,各12例。对照组患儿予以常规治疗,低剂量组患儿在对照组治疗基础上加用低剂量纳洛酮治疗。5组患儿在常规治疗基础上,第1天注射纳洛酮0.01 mg/kg,之后每天静脉滴注不同剂量的纳洛酮:a组为0.01 mg/kg、b组为0.02 mg/kg、c组为0.03 mg/kg、d组为0.04 mg/kg、e组为0.05 mg/kg,4h内完成,3 d为1个疗程。比较患儿临床疗效各项指标恢复正常时间(心率、呼吸及肤色)、神经功能评分。结果低剂量组显效率、总有效率高于对照组(P<0.05)。低剂量组患儿心率、呼吸及肤色恢复正常时间短于对照组(P<0.05)。治疗前低剂量组与对照组患儿神经功能评分比较,差异无统计学意义(P>0.05);治疗后低剂量组患儿神经功能评分高于对照组(P<0.05)。经低剂量纳洛酮治疗的5组患儿临床疗效比较,差异有统计学意义(P<0.05)。5组患儿各项指标恢复正常时间比较,差异有统计学意义(P<0.05)。治疗前5组患儿神经功能评分比较,差异无统计学意义(P>0.05);治疗后5组患儿神经功能评分比较,差异有统计学意义(P<0.05)。结论低剂量纳洛酮治疗窒息新生儿的临床疗效确切,可有效改善患儿神经功能,且随着纳洛酮浓度的增加,其治疗效果更好。
Objective To investigate the clinical efficacy of low-dose naloxone in the treatment of neonatal asphyxia. Methods 90 cases of neonatal asphyxia admitted from May 2014 to November 2015 in Huanggang MCH were randomly divided into low dose group and control group with 45 cases in each group. 60 cases of asphyxial newborns admitted to our hospital from December 2015 to December 2016 were selected. Randomly divided into 5 groups, each 12 cases. Control children with conventional treatment, low-dose group of children in the control group based on the addition of low-dose naloxone treatment. On the basis of routine treatment, the 5 groups were given naloxone 0.01 mg / kg on the first day, then different doses of naloxone were intravenously dripped daily: a was 0.01 mg / kg in group a, 0.02 mg / kg in group b, 0.03 mg / kg in group c, 0.04 mg / kg in group d and 0.05 mg / kg in group e, which was completed in 4 h and 3 courses for 1 d. All the indexes of children’s clinical curative effect were returned to normal time (heart rate, respiration and skin color) and neurological function scores. Results Low-dose group was significantly higher efficiency, total effective rate was higher than the control group (P <0.05). The heart rate, respiration and skin color recovery time of children in low dose group were shorter than those in control group (P <0.05). There was no significant difference in neurological function scores between the low-dose group and the control group before treatment (P> 0.05). After treatment, the neurological score of the low-dose group was higher than that of the control group (P <0.05). The clinical efficacy of 5 groups of children treated with low-dose naloxone was significantly different (P <0.05). The indexes of 5 groups returned to normal, the difference was statistically significant (P <0.05). There was no significant difference in neurological function score between the five groups before treatment (P> 0.05). There was significant difference in neurological function scores between the five groups after treatment (P <0.05). Conclusion Low-dose naloxone is effective in treating neonatal asphyxia, which can effectively improve the neurological function of children. With the increase of naloxone concentration, the treatment effect is better.