The Clinical Study Of Ulinastatin In The Treatment Of Neonatal Hypoxic Ischemic Encephalopathy

ObjectiveNeonatal hypoxic ischemic encephalopathy(HIE)is the main cause of neonatal death,neurobehavioral and long-term disability.Early diagnosis of neonatal hypoxic ischemic encephalopathy and timely treatment is an important way to improve the prognosis and improve the quality of life of neonates with hypoxic ischemic encephalopathy.Therefore,it is very necessary to develop new therapeutic strategies.The aim of this study is to provide ulinastatin for the treatment of neonatal hypoxic ischemic encephalopathy based on the conventional treatment of mild hypothermia,and to analyze the clinical effect of combined treatment of neonatal hypoxic ischemic encephalopathy,so as to provide new ideas for the treatment and prognosis of neonatal hypoxic ischemic encephalopathy.MethodsAll cases was divided into 2 groups by the randomized double blind method,100 cases in each the control group and the experimental group.The control group was treated with mild hypothermia,and the experimental group was treated with ulinastatin 5-10 million U/kg on the basis of the control group for 7 days.7 days after admission respecttively in first,third,fifth,respectively,from the radial artery blood to detect the level of NSE and interleukin-6,tumor necrosis factor content;first,second,third,fourth week were measured on admission NBNA score;first,second,third,4 weeks after admission examination;comparison of two groups of children nervous system symptom recovery time;all the children were followed up to 1 years of age,children’s intelligence devel opment record,and record the sequelae of epilepsy,language disorders,movement disor ders,mental retardation,severe cerebral palsy incidence and infection,scleredema,liver and kidney dysfunction,reduce the platelet count,electrolyte disorders,abnormal blood sugar and other complication.ResultsAfter treatment,second week,third week and fourth week,NBNA scores of the experimental group were significantly higher than the control group,the differences were statistically significant(p<0.05);in the experimental group after treatment,recovery time of reflection,muscle tension and nerve function was significantly shorter than the control group,the difference was statistically significant(p<0.05);3,5,7 days after treatment,the experimental group NSE was significantly lower than the control group,after treatment of serum inflammatory cytokines IL-6 and TNF-were all experimental group decreased significantly,the difference was statistically significant(p<0.05);second,third,fourth week in the experimental group CT value was significantly higher than the control group,the differences were statistically the significance(p<0.05);the follow-up results showed that the experimental group on the mental development and motor development index were significantly higher than the control group,the differences were statistically significant(p<0.05).There was no statistically significant difference in the incidence of complications between the two groups(p>0.05).The incidence of sequelae in the experimental group were lower than those in the control group,but there was no statistically significant difference in the incidence of sequela between the two groups(p>0.05).Conclusions(1)ulinastatin combined with mild hypothermia can significantly improve the NBNA score and reduce the recovery time of nerve function.(2)ulinastatin combined with mild hypothermia could significantly reduce the expression of NSE and inflammatory factors TNF-alpha and IL-6,and the results of CT imaging examination improved significantly.(3)Follow up results showed that ulinastatin combined with mild hypothermia treatment has certain value in the treatment of complications and sequelae,and the treatment effect is safe and reliable.