亚低温与促红细胞生成素联合应用对窒息儿生命体征和内环境的影响

Effect of combination therapy of subhypothermia and erythropoietin on vital signs and internal environment of asphyxied neonates

目的:探讨亚低温与促红细胞生成素的联合应用对窒息新生儿生命体征和内环境的影响,从而对其安全性做出初步评价。方法:把入选病例随机分为联合组(16例)、亚低温组(24例)及常规组(25例),并对各组治疗前、后的生命体征、血糖、电解质、血气等指标进行对照分析。结果:(1)联合组与低温组患儿的心率在低温治疗中下降,但复温后渐回升至正常;治疗84 h内:各组患儿的呼吸频率均无明显改变;联合组的血压与治疗前相比仅舒张压在治疗72 h时差异有统计学意义(P<0.05);(2)联合组治疗后血Na+、血K+、血糖均无明显变化,但出现了低血Ca2+,较治疗前有统计学差异(P<0.05);(3)治疗前、后三组患儿的PCO2均无明显改变且酸中毒均得以纠正。结论:全身亚低温与促红细胞生素的联合应用对窒息儿的生命体征和内环境无明显的不良影响。

Objective To explore the safety of combination therapy of systemic subhypothermia and erythropoietin on asphyxiated neonates. Methods Sixty-five asphyxiated newborns enrolled in this study were randomly divided into combination group（n=16）, hypothermia group （n=24） and conventional group（n=25）. Sign vitals, blood glucose, electrolytes and blood gas were all monitored before treatment as well as after treatment. Results （1）Heart rate decreased in both combination group and hypothermia group during hypothermia treatment, but increased gradually with the recovery of body temperature. Respiration was steady. There were no obvious changes in blood pressure in combination group, though the dilation pressure at 72 hours showed statistical difference compared with that at 0 hour. （2） Blood natrium, kalium and glucose showed no obvious changes, but blood calcium decreased after combination treatment. （3） There was no significant change in PCO2 during the combination treatment. All the asphyxia infants had metabolic acidosis before treatment and were gradually corrected after therapy. Conclusion Combination therapy of systemic subhypothermia and erythropoietin has no adverse effects on vital signs and internal environment of neonatal asphyxia.