医用控温仪对缺氧缺血性脑病新生儿神经行为和神经损伤指标的影响  

The Effect of Medical Temperature Controller on Neurobehavioral and Neurological Injury Indicators in Newborns with Hypoxic-Ischemic Encephalopathy

作　　者：阮露丹 黄优优 李杨丹 Ruan Ludan;Huang Youyou;Li Yangdan(Taizhou Hospital of Zhejiang Province,Taizhou Zhejiang 318050,China)

机构地区：[1]浙江省台州医院,浙江台州318050

出　　处：《医疗装备》2024年第4期11-14,共4页Medical Equipment

摘　　要：目的探讨医用控温仪对缺氧缺血性脑病(HIE)新生儿神经行为和神经损伤标志物的影响。方法选取2019年7月至2021年10月浙江省台州医院收治的74例HIE新生儿作为研究对象,采用随机数字表法分为两组,每组37例。对照组予吸氧、降颅压、镇静及稳定血糖、血压及内环境等常规治疗,试验组在对照组基础上加用医用控温仪。两组均随访至出生后28 d。比较两组意识、反射及肌张力恢复时间,治疗前和出生28 d后的神经行为[采用新生儿神经行为测定量表(NBNA)评估]、发育缺陷程度[采用盖塞尔(Gesell)发育评估表评估]和血清神经损伤指标[神经元烯醇化酶(NSE)和髓鞘碱性蛋白(MBP)]水平,并统计两组1年内神经系统后遗症发生率。结果试验组意识、反射及肌张力恢复时间均短于对照组,差异有统计学意义(P<0.05)。出生28 d后,两组NBNA、Gesell评分均高于治疗前,血清NSE、MBP水平均低于治疗前,且试验组NBNA、Gesell评分高于对照组,血清NSE、MBP水平低于对照组,差异均有统计学意义(P<0.05)。试验组1年内神经系统后遗症发生率低于对照组,差异有统计学意义(P<0.05)。结论医用控温仪用于HIE新生儿中,不仅可加快意识、反射及肌张力恢复,且可改善神经行为,降低发育缺陷程度,减少神经系统后遗症的发生,与其可降低NSE和MBP水平、促进神经恢复和再生密切相关。Objective To explore the effects of medical temperature controllers on neurobehavioral and neuroinjury markers in newborns with hypoxic-ischemic encephalopathy(HIE).Methods With the selection of 74 newborns with HIE admitted to Taizhou Hospital of Zhejiang Province from July 2019 to October 2021 as the research subjects,they were randomly divided into two groups,by using the random number table method,with 37 cases in each group.the control group received routine treatments such as oxygen inhalation,lowering intracranial pressure,sedation,and stabilizing blood sugar,blood pressure,and internal environment,and the experimental group received additional medical temperature control devices in addition to the control group,both groups were followed up until 28 days after birth.The recovery time of consciousness,reflexes,and muscle tone between the two groups,as well as the neurological behavior before treatment and 28 days after birth[evaluated by using the Neonatal Behavioral Neurological Assessment(NBNA)],the degree of developmental defects[evaluated by using the Gesell Developmental Assessment Scale],and serum levels of nerve injury markers[neuron specific enolase(NSE)and myelin basic protein(MBP)]were compared,and the incidence of neurological sequelae within one year in both groups was statistically analyzed.Results The recovery time of consciousness,reflex,and muscle tone in the experimental group was shorter than that in the control group,and the difference was statistically significant(P<0.05).After 28 days of birth,the NBNA and Gesell scores of both groups were higher than before treatment,and the serum NSE and MBP levels were lower than before treatment.In addition,the NBNA and Gesell scores of the experimental group were higher than those of the control group,and the serum NSE and MBP levels were lower than those of the control group,with statistical significance(P<0.05).The incidence of neurological sequelae within one year in the experimental group was lower than that in the control group,and the differe

关 键 词：医用控温仪 缺氧缺血性脑病 新生儿 神经行为 发育缺陷程度 神经损伤标志物 神经系统后遗症 

分 类 号：R722.1[医药卫生—儿科]