选择性头部亚低温治疗新生儿缺氧缺血性脑病临床探讨  

Clinical study of elective cephalic hypothermia for treatment of newborn hypoxic-ischemic encephalopathy

作　　者：徐明[1] 宋磊[1] 魏燕[1] 朱洁[1] 

机构地区：[1]江苏省南通市第一人民医院南通大学第二附属医院儿科,南通226001

出　　处：《南通大学学报（医学版）》2007年第5期359-361,共3页Journal of Nantong University(Medical sciences)

摘　　要：目的:研究选择性头部亚低温治疗新生儿缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)的疗效及安全性。方法:将22例新生儿HIE随机分为常温组、亚低温组各11例,两组患儿均采用常规干预,亚低温组于生后6小时内加用选择性头部亚低温治疗。观察两组患儿治疗前、中、后基本生命体征(体温、呼吸、心率、血压)、血生化(血糖、血电解质及肝功能、肾功能)、血气的变化,并比较两组患儿生后28天20项新生儿神经行为评分。结果:亚低温组和常温组在治疗期间均未出现硬肿、肺出血、心律失常、DIC及难以纠正的低血压等副作用,病死率分别是18.2%(2/11)和27.3%(3/11),差异无统计学意义(P>0.05);与常温组比较,亚低温组治疗72小时后心率减慢(P<0.05),但停止亚低温治疗后差异很快消失(P>0.05);生后28天20项新生儿神经行为评分亚低温组高于常温组,分别为36±9分、29±8分,差异有统计学意义(P<0.05)。结论:选择性头部亚低温治疗新生儿HIE是有效的、安全的。Objective： To study the effect of elective cephalic hypothermia for treatment on newborn hypoxic ischemic encephalopathy（HIE）. Methods： twenty-two cases with HIE were served as therapeutic group. The other cases with HIE were served as the control group. The therapeutic group was treated by elective cephalic hypothermia for 72 hours. The treatment started within 6 hours after birth. The heart rate, rhythm , respiratory rate,non-invasive blood pressure, arterial blood gas, electrolyte, blood glucose and liver and renal functions were monitored. Results： Compared with that in the control group, the heart rate was reduced in therapeutic group. However, there were nodifference of respiratory rate, ion of blood and blood pressure between the two groups. Conclusion： There are no side effects in the treatment of HIE with elective cephalic hypothermia. So it can work well in practice.

关 键 词：缺氧缺血性脑病 新生儿 亚低温 

分 类 号：R722.12[医药卫生—儿科]