重组人促红细胞生成素早期治疗新生儿缺氧缺血性脑病的疗效观察

发布时间：2018-02-15 15:51

本文关键词： 重组人促红细胞生成素新生儿缺氧缺血性脑病　出处：《郑州大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的观察重组人促红细胞生成素（rhEPO）对治疗新生儿缺氧缺血性脑病（HIE）的疗效。方法对86例的HIE患儿随机分为对照组（42例）和治疗组（44例）。两组患儿均给予常规治疗，治疗组在常规治疗的基础上，加用rhEP0，按250u／kg皮下注射，隔日1次，总疗程共14d。分别观测两组患儿神经系统症状的恢复的时间、脑部影像学的改变。治疗组和对照组分别于治疗后28d进行头颅影像学检查，，于生后的7d、14d、28d进行新生儿行为测定（NBNA），于生后的3个月和6个月进行婴幼儿智能发育评估(CDCC)，于生后6个月和12个月进行随访。结果治疗组的肌张力、意识状态以及原始反射的恢复时间明显少于对照组(P0.05)，生后28d复查脑部影像学的改善情况较优于对照组（P0.05），生后7d的NBNA评分治疗组与对照组无明显差异，但在14d、28d时治疗组NBNA评分均比对照组（P0.05）显著增高，治疗组3个月及6个月的心理运动发育指数（PDI）以及智力发育指数（MDI）均较对照组增高，且生后6个月和12个月的随访较理想，患儿遗留后遗症的几率明显减少。结论早期应用rhEP0治疗新生儿HIE疗效明显优于常规治疗。
[Abstract]:Purpose. To observe the therapeutic effect of recombinant human erythropoietin (rhEPO) on neonatal hypoxic ischemic encephalopathy (HIE). Method. 86 cases of HIE were randomly divided into control group (n = 42) and treatment group (n = 44). The total course of treatment was 14 days. The time of recovery of neurological symptoms and the changes of brain imaging were observed in the two groups. The brain imaging examination was performed in the treatment group and the control group on the 28th day after treatment. The neonatal behavior was measured at the end of 14 days and 28 days after birth. The intellectual development of infants was evaluated at 3 and 6 months after birth, and followed up at 6 and 12 months after birth. Results. The recovery time of muscle tension, consciousness and primitive reflex in the treatment group was significantly less than that in the control group (P 0.05), and the improvement of brain imaging on the 28th day after birth was better than that in the control group (P 0.05). There was no significant difference between the treatment group and the control group in the NBNA score on the 7th day after birth. However, the scores of NBNA in the treatment group were significantly higher than those in the control group at 14 days and 28 days after birth. The psychomotor development index and mental development index in the treatment group were higher than those in the control group at 3 and 6 months, and the follow-up at 6 and 12 months after birth was better than that in the control group. The incidence of sequelae in children was significantly reduced. Conclusion. Early application of rhEP0 in the treatment of neonatal HIE is significantly better than routine treatment.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R722.1

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