局部及全身亚低温疗法针对早产儿窒息治疗效果的对比分析  

Comparative analysis of the therapeutic effect of local and systemic mild hypothermia therapy on asphyxia in premature infants

作　　者：王彤[1] 王丽娟[1] 付洪涛[1] 郝玲[2] Wang Tong;Wang Lijuan;Fu Hongtao;Hao Ling(Department of Neonatology,Tangshan Maternal&Child Health Hospital,Tangshan 063000,China;Department of Pediatric,The First Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北省唐山市妇幼保健院新生儿科,唐山063000 [2]河北医科大学第一医院儿科,石家庄050051

出　　处：《广西医科大学学报》2020年第4期727-731,共5页Journal of Guangxi Medical University

基　　金：河北省医学科学研究重点计划课题资助项目(No.ZL20180229)。

摘　　要：目的:探讨局部及全身亚低温疗法在早产儿窒息的治疗效果。方法:收集2016年6月至2019年6月在唐山市妇幼保健院新生儿二科临床确诊的90例重度窒息早产儿(胎龄30~32周)为研究对象,按随机数字表法分组:常规组30例,仅行常规治疗;治疗A组30例,常规+局部亚低温疗法治疗;治疗B组30例,常规+全身亚低温疗法治疗。比较3组患儿生后12 h不良反应,入院时及治疗24 h、48 h、72 h血清肿瘤坏死因子-α、高迁移率族蛋白-1、特异性烯醇化酶水平,以及矫正胎龄达40周后新生儿神经行为测定(NBNA)评分的变化。结果:治疗A组、治疗B组不良反应的发生率低于常规组(均P<0.05);治疗A组不良反应的发生率与治疗B组比较,差异无统计学意义(P>0.05);矫正胎龄达40周后治疗A组第14天新生儿NBNA评分明显高于第3天(P<0.05),第3天和第14天,3组之间的NBNA评分比较,差异均有统计学意义(均P<0.05);治疗后24 h、48 h、72 h,治疗A组及治疗B组患儿血清指标均低于常规组(均P<0.05),治疗后72 h,治疗A组高于治疗B组(P>0.05)。结论:经全身亚低温疗法治疗的患儿脑损伤最轻,恢复最快,对于新生儿缺氧缺血性脑损害治疗效果最好。Objective: To explore the therapeutic effect of local and systemic mild hypothermia therapy on asphyxia in premature infants.Methods: Nity premature infants with severe asphyxia(gestational age 30 to 32 weeks)in Pediatric department of Tangshan Maternal and Child Health Hospital From June 2016 to June 2019 were selected and randomly divided into routine group,A group,and B group according to the random number table method,with 30 cases in each group.Routine group was given routine treatment,A group was given routine + local mild hypothermia therapy,and B group was given routine + systemic mild hypothermia therapy.The adverse reactions at 12 h after birth,the levels of serum TNF-α,high mobility group protein-1,and specific enolase at admission and after 24 h,48 h and72 h of treatment,and the changes of NBNA score after 40 weeks of corrected gestational age were compared among the 3 groups.Results: The incidence of adverse reactions in group A and group B were lower than that in routine group(all P<0.05),but there was no significant difference in the incidence of adverse reactions between group A and group B(P>0.05).After the corrected gestational age reached 40 weeks,the NBNA score of newborns in group A on the 14 th day was significantly higher than that on the 3 rd day(P<0.05),and on the 3 rd and 14 th day,there were significant differences in NBNA scores among the 3 groups(all P<0.05).After 24 h,48 h and 72 h of treatment,the serum indexes in group A and group B were lower than those in routine group(all P<0.05),and after 72 h of treatment,the serum indexes in group A were higher than those in group B(P>0.05).Conclusion: The brain injury of children treated with systemic mild hypothermia therapy is the lightest,the recovery speed is the fastest,and the therapeutic effect is the best for neonatal hypoxic-ischemic brain damage.

关 键 词：局部亚低温疗法 全身亚低温疗法 早产儿 窒息 

分 类 号：R722.1[医药卫生—儿科]