RESUMO
Objective To investigate the curative effect of ganglioside combined with hyperbaric oxygen in treatment of neonatal hypoxic ischemic encephalopathy (HIE)and its influence on serum neuronspecific enolase (NSE).Methods 92 cases of children with HIE were randomly divided into two groups,each group in 46 cases. They were all given routine therapy,and added the citicoline for treatment at third day after being hospitalized,and the observation group were treated with ganglion ganglioside combined with hyperbaric oxygen on the basis of that.Clinical treatment effect and neonatal behavioral neurological(NBNA)scores,serum neuron specific enolase (NSE)levels of the two groups before and after treatment were observed and compared.Results The total effective rate of the obser-vation group was 93.48%,which was significantly higher than 76.09% of the control group (χ2 =10.02,P <0.05);NBNA score of the observation group after treatment were (38.92 ±4.10)points,which was significantly higher than that before treatment (t =8.00,P <0.05)and the control group (t =6.89,P <0.05);while its serum NSE was (9.56 ± 2.03)μg/L,which was significantly lower than before treatment(t =8.31,P <0.05)and the control group(t =7.12, P <0.05).Conclusion The ganglioside combined with hyperbaric oxygen therapy has a significant effect for hypoxic ischemic encephalopathy,which can significantly decrease the serum NSE level,improve neurological function and has a better clinical application value.
RESUMO
Objective To investigate the efficacy and safety of nasal intermittent positive pressure ventilation and tracheal intubation synchronized intermittent positive pressure ventilation in treatment of neonatal respiratory dis-tress syndrome.Methods According to number table methods,60 children with RDS and the need for respiratory support and hospitalization were randomly divided into the intubation synchronized intermittent positive pressure venti-lation group(SIPPV+VG group) and the nasal intermittent positive pressure ventilation group(NIPPV group),each group 30 cases.The two groups were given pulmonary surfactant( PS) replacement therapy,and the respiratory support 0h,12h,4h,72h fraction of inspired oxygen(FiO2),partial pressure of carbon dioxide (PaCO2),partial pressure of oxygen(PaO2),mean airway pressure(MAP),blood oxygen saturation(SaO2),P/F(PaO2/FiO2),arterial/alveolar oxygen partial pressure ratio( a/APO2 ) were recorded. The efficacy and safety of the two groups after treatment were analyzed.Results The two groups of MAP,FiO2 and P/F(PaO2/FiO2) showed significant differences(F=153.247, 187.385,376.587,128.509,430.276,259.507,all P<0.05) after 0h,12h,24h,72h and the differences between 0h and 12h,24h,72h also respectively had statistical significance(P<0.05);PaO2,SaO2,a/APO2 showed significant differences between the two groups (F=732.756,987.835,796.37,683.508,735.375,679.509,all P<0.05),and the differences of 0h and 12h,24h,72h also respectively had statistical significance(all P<0.05);VAP and gas leak-age had significant difference between the two groups(P=0.039,0.021).Conclusion Both the two methods can effectively improve the oxygenation state,promote gas exchange function in children with NRDS,the NIPPV method can further reduce the incidence of VAP and gas leakage , which is clinically preferred noninvasive mechanical ventilation method.