选择性头部亚低温对足月新生儿重度窒息的早期干预

Early Intervention of Selective Head Sub-hypothermia in Full Term Infant with Severe Asphyxia

目的研究选择性头部亚低温对足月新生儿重度窒息的早期干预效果。方法将42例足月重度窒息新生儿分为干预组22例，对照组20例，全部患儿治疗复苏后在三项支持、三项对症治疗方案进行治疗的基础上，干预组加用选择性头部亚低温治疗，两组均于治疗后72h测心率、呼吸效率、血压、经皮测血氧饱和度（SpO2）、血糖，两组均于出生28d采用中国20项新生儿神经行为评分，并于出生后2个月做Bayley婴儿量表检查。结果治疗后72h干预组心率减慢，与对照组差异有统计学意义（P〈0．05），停止治疗后恢复正常；出生28d新生儿神经行为评分治疗组（37±3）分，对照组（31±3）分，差异有统计学意义（P〈0．01）；出生后2个月婴儿发育量表干预组（91-4-3）分，对照组（86±4）分，差异有统计学意义（P〈0．05）。结论亚低温治疗重度窒息安全、简便，疗效可靠，对于减轻脑损伤，提高生存质量有积极作用。

Objective To study the curative effect of early intervention on selective head sub-hypothermia in full term infant with severe asphyxia. Methods Forty two full term infant with severe asphyxia were randomly divided into treatment（ n = 22） and control （n = 20） group, all patients were treated according to ＂three supportive therapy and three heteropathy＂ after resuscitation, and meanwhile the treament group combined with selective head sub-hypothermia. In the 2 groups, heart and breath oxygen saturation, blood sugar were measurded within 72 hours after treat- ment, and the Chinese 20-item neonate nerve behaviors were evaluated 28 days after birth. Test were conducted with the Bayley infant development scale in 2 months after birth. Results After 72 hours of treatment, the heart rate of treatment group reduced and showed significant difference from that of contol group and restored to normal. There were no significant differences in breath, blood pressure（ BP）, degree of blood ozygen saturation, blood sugar between the 2 groups. After 28 days of birth, scores of neonate nerve behaviors were（ 37 ± 3 ） in treatment group and（ 31 ± 3 ） in control group, respectively ;which showed significant difference （P 〈 0.01 ）. In the 2nd months of birth, scores of Bayley infant development scale were（91 ± 3 ） in treatment group and （86 ± 4） in control group, respectively, which showed significant difference （ P 〈 0.05）. Conclusion Selective head sub-hypothermia was convenient and safe, and had reliable curative effect by relieving or prenventing sequel and raising quality of life.