综合干预疗法联合单唾液酸四己糖神经节苷脂钠注射液对脑损伤综合征患儿的影响
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摘要
目的探讨综合干预疗法联合单唾液酸四己糖神经节苷脂钠注射液对脑损伤综合征患儿的影响。方法选取2015年6月—2016年6月临沂市妇女儿童医院收治的脑损伤综合征患儿88例,采用随机数字表法分为对照组与观察组,每组44例。对照组患儿行综合干预疗法,观察组患儿在对照组基础上予以单唾液酸四己糖神经节苷脂钠注射液治疗(连续治疗6周)。比较两组患儿治疗前后Gesell发育诊断量表评分、粗大运动功能评定量表(GMFM)评分,治疗前及治疗1、3个月新生儿行为神经测定(NBNA)评分,并观察两组患儿随访期间脑瘫发生情况。结果治疗前两组患儿适应性行为评分、大运动行为评分、精细动作行为评分、语言行为评分、个人-社交行为评分比较,差异无统计学意义(P>0.05);治疗后观察组患儿适应性行为评分、大运动行为评分、精细动作行为评分、语言行为评分、个人-社交行为评分高于对照组(P<0.05)。治疗前两组患儿A区评分、B区评分、C区评分、D区评分、E区评分比较,差异无统计学意义(P>0.05);治疗后观察组患儿A区评分、B区评分、C区评分、D区评分、E区评分高于对照组(P<0.05)。治疗前两组患儿NBNA评分比较,差异无统计学意义(P>0.05);治疗1、3个月观察组患儿NBNA评分高于对照组(P<0.05)。随访期间观察组患儿脑瘫发生率低于对照组(P<0.05)。结论综合干预疗法联合单唾液酸四己糖神经节苷脂钠注射液可有效促进脑损伤综合征患儿智力发育,改善患儿粗大运动功能和神经功能,降低脑瘫发生风险。
Objective To investigate the impact of comprehensive intervention therapy combined with monosialotetrahexosyl ganglioside sodium injection on children with brain injury syndrome.Methods A total of 88 children with brain injury syndrome were selected in the Women and Children's Hospital of Linyi from June 2015 to June 2016,and they were divided into control group observation group according to random number table,each of 44 cases.Children in control group received comprehensive intervention therapy,while children in observation group received monosialotetrahexosyl ganglioside sodium injection for 6 weeks based on that of control group.Gesell Development Diagnosis Scale score,Gross Motor Fuction Measure(GMFM) score before and after treatment,Neonatal Behavioral Neurological Assessment(NBNA) score before treatment,1 month and 3 months after treatment were compared between the two groups,and incidence of brain paralysis was observed during the follow-up.Results No statistically significant differences of adaptive behavior score,major motor behavior score,fine motor behavior score,linguistic performance score or personal-social behavior score was found between the two groups before treatment(P>0.05),while adaptive behavior score,major motor behavior score,fine motor behavior score,linguistic performance score and personal-social behavior score in observation group were statistically significantly higher than those in control group after treatment(P<0.05).No statistically significant differences of A section score,B section score,C section score,D section score or E section score was found between the two groups before treatment(P>0.05),while A section score,B section score,C section score,D section score and E section score in observation group were statistically significantly higher than those in control group after treatment(P<0.05).No statistically significant differences of NBNA score was found between the two groups before treatment(P>0.05),while NBNA score in observation group was statistically significantly higher that that in control group 1 month and 3 months after treatment,respectively(P<0.05).Incidence of brain paralysis in observation group was statistically significantly lower than that in control group during the follow-up.Conclusion Comprehensive intervention therapy combined with monosialotetrahexosyl ganglioside sodium injection can effectively promote the intelligence development,gross motor function and neurological function,reduce the risk of brain paralysis in children with brain injury syndrome.
Objective To investigate the impact of comprehensive intervention therapy combined with monosialotetrahexosyl ganglioside sodium injection on children with brain injury syndrome.Methods A total of 88 children with brain injury syndrome were selected in the Women and Children's Hospital of Linyi from June 2015 to June 2016,and they were divided into control group observation group according to random number table,each of 44 cases.Children in control group received comprehensive intervention therapy,while children in observation group received monosialotetrahexosyl ganglioside sodium injection for 6 weeks based on that of control group.Gesell Development Diagnosis Scale score,Gross Motor Fuction Measure(GMFM) score before and after treatment,Neonatal Behavioral Neurological Assessment(NBNA) score before treatment,1 month and 3 months after treatment were compared between the two groups,and incidence of brain paralysis was observed during the follow-up.Results No statistically significant differences of adaptive behavior score,major motor behavior score,fine motor behavior score,linguistic performance score or personal-social behavior score was found between the two groups before treatment(P>0.05),while adaptive behavior score,major motor behavior score,fine motor behavior score,linguistic performance score and personal-social behavior score in observation group were statistically significantly higher than those in control group after treatment(P<0.05).No statistically significant differences of A section score,B section score,C section score,D section score or E section score was found between the two groups before treatment(P>0.05),while A section score,B section score,C section score,D section score and E section score in observation group were statistically significantly higher than those in control group after treatment(P<0.05).No statistically significant differences of NBNA score was found between the two groups before treatment(P>0.05),while NBNA score in observation group was statistically significantly higher that that in control group 1 month and 3 months after treatment,respectively(P<0.05).Incidence of brain paralysis in observation group was statistically significantly lower than that in control group during the follow-up.Conclusion Comprehensive intervention therapy combined with monosialotetrahexosyl ganglioside sodium injection can effectively promote the intelligence development,gross motor function and neurological function,reduce the risk of brain paralysis in children with brain injury syndrome.
引文
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[13]曹惠鹃,张振,张铁铮,等.单唾液酸神经节苷脂对体外循环大鼠炎性反应的影响[J].中华麻醉学杂志,2013,33(1):119-122.DOI:10.3760/cma.j.issn.0254-1416.2013.01.033.
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[18]唐彦,张凡,窦艳霞,等.神经节苷脂联合丁苯酞治疗急性分水岭脑梗死的临床疗效及其对血液流变学和血清同型半胱氨酸水平的影响研究[J].实用心脑肺血管病杂志,2017,25(3):42-45.DOI:10.3969/j.issn.1008-5971.2017.03.010.
[19]晏小琼,谭倩,余丹芳,等.单唾液酸四己糖神经节苷脂钠注射液联合多巴丝肼治疗帕金森病的临床疗效及对患者认知功能的影响研究[J].实用心脑肺血管病杂志,2016,24(6):34-37.DOI:10.3969/j.issn.1008-5971.2016.06.009.
[20]金玲,黄民江,李洪亮,等.神经节苷脂对实验性颅脑外伤大鼠的保护作用及机制[J].中国康复医学杂志,2013,28(12):1142-1145.DOI:10.3969/j.issn.1001-1242.2013.12.013.
[2]冀浩然,肖江喜,李东晓,等.GM1神经节苷脂累积病6例患儿临床及遗传学研究[J].中华实用儿科临床杂志,2016,31(20):1536-1540.DOI:10.3760/cma.j.issn.2095-428X.2016.20.004.
[3]许萍,袁红琴.单唾液酸四己糖神经节苷脂应用于早期新生儿缺氧缺血性脑病的效果[J].中国妇幼保健,2013,28(15):2391-2393.DOI:10.7620/zgfybj.j.issn.1001-4411.2013.28.19.
[4]王盛,王朝平,陈太董,等.神经节苷脂联合银杏达莫对颅脑损伤患者的临床研究[J].中国临床药理学杂志,2016,32(12):1075-1077.DOI:10.13699/j.cnki.1001-6821.2016.12.006.
[5]王宁群,李长达.神经系统疾病[M].北京:中国中医药出版社,2007:201-203.
[6]张耿标,周志成.核心肌群训练治疗脑损伤伴平衡障碍及共济失调的疗效观察[J].实用心脑肺血管病杂志,2014,22(1):111-112.
[7]BLUM F C,CHEN C,KROKEN A R,et al.Tetanus toxin and botulinum toxin a utilize unique mechanisms to enter neurons of the central nervous system[J].Infect Immun,2012,80(5):1662-1669.DOI:10.1128/IAI.00057-12.
[8]王红,高美玲,兰婧,等.神经节苷脂在神经再生中的作用[J].山西医科大学学报,2015,46(9):936-940.DOI:10.13753/j.issn.1007-6611.2015.09.027.
[9]唐久来,李海华,史惟,等.小儿脑性瘫痪诊疗指南探讨[J].实用儿科临床杂志,2009,24(24):1914-1917.
[10]孙茂林,张杰.单唾液酸四己糖神经节苷脂钠治疗脑外伤癫痫疗效分析[J].中国临床药理学杂志,2012,28(10):734-736.DOI:10.3969/j.issn.1001-6821.2012.10.005.
[11]ZHU X Y,YE M Y,ZHANG A M,et al.Influence of one-year neurologic outcome of treatment on newborns with moderate and severe hypoxic-ischemic encephalopathy by rhu EPO combined with ganglioside(GM1)[J].Eur Rev Med Pharmacol Sci,2015,19(20):3955-3960.
[12]赵志霞.综合干预疗法治疗小儿脑损伤综合征的疗效观察[J].中国实用神经疾病杂志,2016,19(11):73-74.DOI:10.3969/j.issn.1673-5110.2016.11.039.
[13]曹惠鹃,张振,张铁铮,等.单唾液酸神经节苷脂对体外循环大鼠炎性反应的影响[J].中华麻醉学杂志,2013,33(1):119-122.DOI:10.3760/cma.j.issn.0254-1416.2013.01.033.
[14]王晓虹,王虹,车菊华,等.神经节苷脂对体外培养一氧化碳损伤少突胶质细胞Nogo-A的影响[J].中国组织工程研究,2015,19(6):945-949.DOI:10.3969/j.issn.2095-4344.
[15]UENO H,YAMAGUCHI T,FUKUNAGA S,et al.Comparison between the aggregation of human and rodent amyloidβ-proteins in GM1 ganglioside clusters[J].Biochemistry,2014,53(48):7523-7530.DOI:10.1021/bi501239q.
[16]蒋滔滔,高延,罗小杏,等.脑氧饱和度检测对脑损伤综合征婴儿脑功能的评定[J].中国儿童保健杂志,2015,23(5):460-461,555.DOI:10.11852/zgetbjzz2015-23-05-05.
[17]BLUM F C,TEPP W H,JOHNSON E A,et al.Multiple domains of tetanus toxin direct entry into primary neurons[J].Traffic,2014,15(10):1057-1065.DOI:10.1111/tra.12197.
[18]唐彦,张凡,窦艳霞,等.神经节苷脂联合丁苯酞治疗急性分水岭脑梗死的临床疗效及其对血液流变学和血清同型半胱氨酸水平的影响研究[J].实用心脑肺血管病杂志,2017,25(3):42-45.DOI:10.3969/j.issn.1008-5971.2017.03.010.
[19]晏小琼,谭倩,余丹芳,等.单唾液酸四己糖神经节苷脂钠注射液联合多巴丝肼治疗帕金森病的临床疗效及对患者认知功能的影响研究[J].实用心脑肺血管病杂志,2016,24(6):34-37.DOI:10.3969/j.issn.1008-5971.2016.06.009.
[20]金玲,黄民江,李洪亮,等.神经节苷脂对实验性颅脑外伤大鼠的保护作用及机制[J].中国康复医学杂志,2013,28(12):1142-1145.DOI:10.3969/j.issn.1001-1242.2013.12.013.