新生儿缺氧缺血性脑病治疗误区及程序化干预策略

The Pitfalls in the Treatment of Hypoxicischemic Encephalopathy and Programmed Intervention Strategy

新生儿缺氧缺血性脑病(hypoxicischemic encephalopathy,HIE)主要是指围生期窒息导致的缺氧缺血性脑损伤(hypoxicischemic brain damage,HIBD)。多年来对HIE的干预存在较多争论,本文辩证分析了目前国内HIE治疗的误区,提出对于HIE的干预,需要从机理入手。缺氧缺血事件的不同阶段有不同的矛盾,而且这些矛盾是动态变化的,辩证的对待不同阶段所面临的矛盾是确定干预措施的基础,主张在时间窗内、急性期后、新生儿期后等不同的时间段内采取针对性强、连续的干预策略,初步提出程序化干预的概念。

Hypoxicischemic encephalopathy（HIE） is mainly referred to the hypoxicischemic brain damage（HIBD） caused by neonatal asphyxia in perinatal stage. Some arguments about HIE have been existing for many years. Recently , treatment about HIE has some pitfalls in China. This article mentions that the interventions about HIE need beginning with it＇s pathogenesy. Different stage of HIE has different contradictionj which is changing dynamically, the critical treatment about this contradiction in every stage is the basis of deciding the intervention strategy. Strong different direction intervention continuously in different period such as in time window, post--acute stage, post--neonatal period should be advocated. The concept of programmed intervention is setted out.