全身亚低温治疗新生儿缺氧缺血性脑病的疗效分析  

A study of protective effect of systemic hypothermia on neonatal hypoxia-ischemia encephalopathy

作　　者：吉玲[1] 朱长连[1] 程秀永[1] 徐发林[1] 李同川[1] 

机构地区：[1]郑州大学第三附属医院儿科,河南郑州450052

出　　处：《中国实用儿科杂志》2007年第8期609-611,共3页Chinese Journal of Practical Pediatrics

基　　金：河南省医药卫生创新人才基金(200084001);河南省重大科技攻关项目(0122032100);河南省高校创新人才基金(0223034700)

摘　　要：目的探讨全身亚低温对新生儿缺氧缺血性脑病的近期和远期疗效。方法2002-08—2004-12郑州大学第三附属医院儿科收治的49例新生儿缺氧缺血性脑病患儿随机分为亚低温治疗组(24例)和对照组(25例),低温组在生后2～10h内给予全身亚低温治疗,维持肛温在(33～34)℃,持续72h,对照组在监护下维持肛温在(37·0±0·5)℃,两组急性期及恢复期其余治疗措施相同。通过对两组患儿不同时期神经学评分、新生儿神经行为测定及婴幼儿智能运动发育检测等来评价亚低温治疗新生儿缺氧缺血性脑病的远近期疗效。结果(1)神经学评分:两组患儿在治疗前神经学评分比较无明显统计学差异。但低温组在治疗12h、24h、48h、72h及80h的神经学评分均低于对照组,两组相比有统计学差异(P<0·05)。(2)神经行为测定:两组患儿分别在生后7d、14d和28d做NBNA检测,14d和28d的NBNA测定,低温组测定值明显高于对照组,P值均<0·05。(3)婴幼儿CD-CC智能发育评估:3个月、6个月、12个月、18个月时,低温组智能发育指数(MDI)和运动发育指数(PDI)均明显高于对照组,两组比较有显著性差异。结论全身亚低温治疗对新生儿缺氧缺血性脑病有明显的近期和远期神经保护作用。Objective To investigate the short and long term neuroprotective effects of systemic hypothermia on neonatal HIE. Methods Fourty-nine asphyxiated newborn infants in the third affiliated hospital of Zhengzhou university were randomized to either systemic hypothermia group （ HG） （ n =24） or normothermia group （ NG） （ n =25）. The infants in hypothermia group were got parental consent and maintained rectal temperature 33.0 - 34. 0℃ for 72h by cooling, device. The other supportive treatments were the same in both groups. Neurological signs, Neonatal Behavioral Neurological Assessment （NBNA） and Intellectual Development Table made by Children＇s Development Center of China （ CDCC）were proceeded to evaluate the protective effects of systemic hypothermia on neonatal. Results 1 ） Neurological signs ： Significant lower in neurological signs was observed on 12h,24h,48h,72h and 80h after treatment in HG than that of in NG. 2） NBNA ： the score of NBNA was much higher at 14 and 28d in hypothermia group than that of normothermia groups. 3 ） CD- CC assessment： Significant higher score of MDI and PDI was found at 3,6,12 and 18 month age in hypothermia groups than that of normothermia groups. Conclusion There are short and long term neuroprotective effects of systemic hypothermia on neonatal HIE.

关 键 词：脑缺氧 脑缺血 脑损伤 亚低温 新生儿 

分 类 号：R722.12[医药卫生—儿科]