新生儿缺氧缺血性心脏损害早期诊疗的预后探讨

Early diagnosis and treatment of neonatal hypoxic-ischemic encephalopathy

目的:研究新生儿缺氧缺血性心脏损害(HIM)早期诊断和及早微量多巴胺治疗对HIM预后的影响,探讨改善预后的措施。方法:对63例窒息新生儿48 h肌酸激酶同功酶(CK-MB)及心电图QT间期弥散度(QTcd)明显异常的HIM患儿及早微量多巴胺治疗,1-2周后再复查并与32例无窒息新生儿对照比较。结果:HIM组与对照组比较患儿发病48 h内CK-MB及QTcd均明显升高(P<0.001),经及早微量多巴胺治疗等措施1-2周后HIM患儿CK-MB及QTcd均显著下降,而产后缺氧组较胎儿期缺氧组下降更明显(P<0.005),且胎儿期缺氧组并发症多,预后差(P<0.005)。结论:CK-MB及QTcd相结合可作为HIM早期诊断指标,及早微量多巴胺治疗等措施,对改善预后意义重大。

Objective:To study and discuss the treatment on the neonatal hypoxic-ischemic encephalopathy (HIM) and how to improve the curative effects. Methods: 63 HIM babies' CK-MB and QTcd were obviously abnormal by giving them a small amount of dopamine, compare them with 32 healthy new-born babies a week later. Results: The treating method of small close dopamine is very useful for those new-born babies whose CK-MB and QTcd were high (P<0.001) and would make their CK-MB and QTcd lower (P<0.005). At the same time , this kind of method would make them recover better from the illness. Conclusion: CK-MB and QTcd as the criterion of diagnosing, the early HIM and the treating method of small amount of dopamine mean a lot to recovery from the illness.