ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2022, Vol. 14 ›› Issue (2): 157-160.

• 临床研究 • 上一篇    下一篇

亚低温治疗新生儿缺氧缺血性脑病的疗效观察

  

  • 出版日期:2022-04-25 上线日期:2023-12-01

Effect of mild hypothermia on neonatal hypoxic ischemic encephalopathy

  • Published:2022-04-25 Online:2023-12-01

摘要: 目的 探讨亚低温治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法 选取2015年1月至2019年12月郑州大学附属儿童医院新生儿科收治的生后6~24 h的HIE患儿为研究对象,随机分为观察组和对照组各45例。对照组采用常规治疗及重组人促红细胞生成素500 U/(kg·次),每周3次,疗程2周。观察组在对照组治疗基础上给予全身亚低温治疗,时间72 h。所有患儿治疗前和治疗3 d后行aEEG监测,同时在生后3 d、5 d、7 d进行神经学评分,生后7 d、14 d、28 d进行新生儿神经行为测定,生后3、6个月进行发育商测定。结果 观察组治疗3 d后aEEG评分高于对照组,差异有统计学意义(P<0.05)。两组患儿生后3 d的神经学评分比较差异无统计学意义(P>0.05),观察组生后5 d、7 d的神经学评分低于对照组,差异有统计学意义(P<0.05)。观察组患儿生后7 d、14 d、28 d的新生儿神经行为评分均高于对照组,差异有统计学意义(P<0.05)。观察组患儿生后3个月和6个月的发育商均高于对照组,差异有统计学意义(P<0.05)。结论 对于新生儿HIE生后6~24 h开始给予的延迟全身亚低温治疗能促进HIE患儿神经功能的早期恢复

关键词:

新生儿缺氧缺血性脑病, 延迟, 亚低温, 疗效

Abstract:

ObjectiveTo explore the effect of mild hypothermia on neonatal hypoxic ischemic encephalopathy(HIE).MethodsA total of 45 HIE children who were admitted to our hospital within 6 to 24 hours after birth were randomly divided into treatment group and control group with 45 in each group. The control group was treated with routine treatment and rhEPO 500 U/(kg·time), 3 times/week for 2 weeks. The treatment group was treated with systemic mild hypothermia for 72 hours in addition to the treatment for control group. All children were monitored by aEEG before treatment and 3 days after treatment. Neurological scores were measured on day 3, 5 and 7 after birth. Neonatal neurobehavioral assessment(NBNA) was performed on day 7, 14 and 28 after birth. Developmental quotient(DQ) was measured at 3 and 6 months after birth.ResultsThe aEEG scores of the treatment group were significantly higher than those of the control group after 3 days of treatment(P<0.05), while there was no difference in neurological scores between the two groups at 3 days after birth(P>0.05).The neurological scores at 5 and 7 days after birth were lower in the treatment group than in the control group(P<0.05). The neonatal neurobehavioral scores at 7, 14 and 28 days after birth were higher in the treatment group were higher than those in control group(P<0.05). The scores in developmental quotient at 3 and 6 months after birth were higher in treatment group than in control group(P<0.05).ConclusionFor neonatal hypoxic-ischemic encephalopathy, delayed systemic hypothermia treatment starting from 6 to 24 hours after birth can promote the early recovery of neurological function in HIE children.

Key words:

Neonatal hypoxic ischemic encephalopathy, Delayed, Hypothermia, Curative effect