头部亚低温治疗新生儿HIE的临床疗效分析  

Clinical curative effect of head mild hypothermia treatment on neonatal hypoxic-ischemic encephalopathy

作　　者：潘兆军[1] 周利[2] 高子波[1] 丁素芳[1] 韩良荣[1] 胡金绘[1] 

机构地区：[1]扬州大学医学院附属淮安市妇幼保健院新生儿医学中心,江苏淮安223002 [2]徐州医学院附属淮安医院儿科,江苏淮安223002

出　　处：《中国妇幼健康研究》2016年第12期1494-1497,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨头部亚低温治疗对新生儿缺氧缺血性脑病（HIE）的临床疗效。方法将2012年7月至2015年6月淮安市妇幼保健院新生儿医学中心收治的50例中、重度新生儿HIE患儿随机分为亚低温组和对照组,亚低温组在生后6小时内给头部亚低温治疗72小时,直肠温度维持在（34.5～35.5）℃;对照组监护下维持直肠温度（36.5～37.5）℃,两组其它治疗措施相同。比较两组患儿治疗的不良反应、新生儿神经行为评分、动态脑电图评价头部亚低温治疗对新生儿HIE的临床疗效。结果1头部亚低温治疗对新生儿HIE治愈好转率与对照组比较差异无统计学意义（P=0.508）;2头部亚低温治疗的不良反应发生率与对照组类似,两组比较差异均无统计学意义（均P〉0.05）;3两组患儿在生后7、14、28天进行新生儿神经行为评分（NBNA）测定,14天和28天时亚低温组的评分均高于对照组,两组比较差异均有统计学意义（t值分别为2.085、2.136,均P〈0.05）;4治疗72小时后患儿中对照组中、重度异常动态脑电图发生率高于亚低温组,差异无统计学意义（P=0.758）。结论头部亚低温治疗对中、重度新生儿HIE是安全有效的一种措施具有近期的神经保护作用。Objective To investigate the clinical curative effect of head mild hypothermia treatment on neonatal hypoxic-ischemic encephalopathy（ HIE）. Methods Totally 50 infants with moderate or severe neonatal（ HIE） during July 2012 to June 2015 in Neonatal Medical Center of Huai＇an Maternity and Child Healthcare Hospital Affiliated to Yangzhou University Medical Academy were randomly divided into mild hypothermia group and control group. The infants in mild hypothermia group were treated with mild hypothermia for 72 hours within 6 hours after birth,and their rectal temperature was maintained at 34. 5℃ to 35. 5℃. In the control group,the rectal temperature of was maintained at 36. 5℃ to 37. 5℃ under monitoring. The other supportive treatments were same in two groups. Adverse reactions,neonatal behavioral neurological assessment（ NBNA） and ambulatory EEG were compared to evaluate the clinical curative effect of head mild hypothermia treatment on neonatal HIE. Results There was no significant difference in the cure rate of head mild hypothermia in neonatal HIE between mild hypothermia group and the control group（ P = 0. 508）. The incidence of adverse reactions of head mild hypothermia treatment in mild hypothermia group was similar to that in the control group,and there was no significant difference between two groups（ both P 〉0. 05）. According to the scores of NBNA in 7d,14 d and 28 d after birth,the scores of mild hypothermia group were higher than those of control group at 14 d and 28 d after birth. There were significant statistics differences between two groups（ t value was2. 085 and 2. 136,respectively,both P 〈0. 05）. After treatment for 72 hours,the incidence of moderate and severe abnormal dynamic EEG in the control group was higher than that in mild hypothermia group,and the difference was not statistically significant（ P = 0. 758）.Conclusion Head mild hypothermia therapy is safe and effective for moderate and severe neonatal HIE,and can protect the nerves in short term.

关 键 词：新生儿 缺氧缺血性脑病 亚低温 不良反应 新生儿神经行为评分 

分 类 号：R722.1[医药卫生—儿科]