亚低温治疗新生儿缺氧缺血性脑病临床效果研究  

Effect of mild hypothermia therapy on neonatal hypoxic ischemic encephalopathy

作　　者：李炎[1] 潘健崧 张文明[1] 黎炽旺 林日亮[1] 陈学馨 陈宏香[1] 

机构地区：[1]梅州市人民医院新生儿科,广东梅州514031

出　　处：《中国医学前沿杂志（电子版）》2017年第5期92-95,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：广东省医学科学技术研究基金项目(B2015143);梅州市科技局立项(2014B102)

摘　　要：目的探讨亚低温治疗新生儿缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)的临床效果。方法连续性收集本院2013年8月至2016年6月收治的采取亚低温联合传统方法治疗的HIE新生儿40例纳入观察组,收集同期本院收治的仅采取传统方法治疗的HIE新生儿47例纳入对照组。所有新生儿均随访至出生后6个月。比较两组新生儿的病死率、并发症发生率、神经系统症状消失时间、新生儿神经行为测定(neonatal behavioral neurological assessment,NBNA)评分、智能发育指数、运动发育指数。结果两组新生儿病死率比较差异无显著性(2.50%︰6.38%,P=0.389)。出生后1个月和6个月,观察组新生儿智能发育指数均显著高于对照组[(91.57±7.57)︰(83.28±8.19),P=0.000]和[(95.38±9.56)︰(87.52±8.77),P=0.000],神经系统症状消失时间均显著短于对照组[(17.57±4.23)天︰(20.48±4.82)天,P=0.004],运动发育指数均显著高于对照组[(88.65±6.62)︰(83.07±6.29),P=0.000]和[(98.57±10.47)︰(91.82±9.18),P=0.002]。两组新生儿出生后第2天NBNA评分无显著差异[(25.63±6.3)分︰(24.68±5.83)分,P=0.472]。出生后第7天和第28天时,观察组新生儿NBNA评分均显著高于对照组[(33.83±5.93)分︰(29.17±6.15)分,P=0.001]和[(35.93±5.48)分︰(32.83±5.54)分,P=0.011]。两组新生儿各种并发症发生率比较差异均无显著性(P>0.05)。结论亚低温治疗可显著改善HIE新生儿的神经发育情况,且安全可靠。Objective To investigate the clinical effect of mild hypothermia therapy on neonatal hypoxic ischemic encephalopathy （HIE）. Method From August 2013 to June 2016 in our hospital, according to the treatment methods, 40 neonate with HIE were prospectively collected as observation group. 47 neonate with HIE were collected as control group at the same time in our hospital. The traditional treatments were given to all neonates while at the same time, neonates in observation group received mild hypothermia treatment. All neonates were followed up to 6 months. The mortality, complications, neurological symptoms disappeared time, neonatal behavioral neurological assessment （NBNA） score, intelligence development index, motor development index of the two groups were studied and compared. Result There was no significant difference in mortality between the two groups （2.50% ︰ 6.38%, P = 0.389）. At 1 month and 6 months since birth, intelligence development indexes of observation group neonates were higher than control group neonates [（91.57±7.57） ︰ （83.28±8.19）, P = 0.000）] and [（95.38±9.56） ︰ （87.52±8.77）, P = 0.000], neurological symptoms disappeared time of observation group neonates were shorter than control group neonates [（17.57±4.23） days ︰ （20.48±4.82） days, P = 0.004], motor development index of observation group neonates were higher than control group neonates [（88.65±6.62） ︰ （83.07±6.29）, P = 0.000] and [（98.57±10.47） ︰ （91.82±9.18）, P = 0.002]. There were no significant differences in NBNA scores between the two groups at the second day since birth [（25.63±6.36） ︰ （24.68±5.83）, P = 0.472]. At 7 and 28 days since birth, NBNA scores of observation group neonates were higher than control group neonates [（33.83±5.93） ︰ （29.17±6.15）, P = 0.001] and [（35.93±5.48） ︰ （32.83±5.54）, P = 0.011]. There were no significant differences in incidence rates of complications between the two groups （P 〉 0.05）. Conclus

关 键 词：亚低温 新生儿 缺氧缺血性脑病 神经发育 

分 类 号：R742[医药卫生—神经病学与精神病学]