生后6～12h开始亚低温治疗对新生儿缺氧缺血性脑病预后的影响

The effects of mild hypothermia therapy after birth of 6～12h on hypoxic-ischemic encephalopathy of neonates

目的：探讨生后6~12 h 开始选择性头部亚低温治疗对新生儿缺氧缺血性脑病预后的影响。方法将中度缺氧缺血性脑病新生儿40例随机分为对照组与观察组：对照组（常温组）18例，观察组（生后6~12 h 实施亚低温）22例。所有患儿给予相同的支持对症治疗。观察组患儿给予选择性头部亚低温治疗，维持肛温（34.0±0.5）℃，持续72 h，患儿在3、6月龄时用中国标准化的贝来量表（ CDCC）测智力发育指数（ MDI）和运动发育指数（PDI）。结果两组患儿的 MDl 分别为73.2±11.2和80.7±10.3。PDl 分别为77.2±9.3和84.5±10.2。观察组 MDl、PDl 均高于对照组，差异有统计学意义（P 〈0.05）。结论中度缺氧缺血性脑病新生儿生后6~12 h 开始选择性头部亚低温治疗仍可有不同程度的神经保护作用。

Objective：To investigate the effects of mild hypothermia therapy after birth of 6 ~ 12 h on hypoxic - ische-mic encephalopathy of neonates. Methods：All 40 cases newborns of moderate hypoxia ischemic encephalopathy were ran-domly divided into the control and observation group：the control groups（n = 18）were normal temperature,and the obser-vation group（n = 22）were treated with mild hypothermia therapy after birth of 6 ~ 12 h. All newborns were treated with the same therapy. Furthermore,the newborns in the observation group was treated with selective brain hypothermia therapy to maintain rectal temperature（34. 0 ± 0. 5）℃ for 72 h. The Chinese standardization BeNAN Scale（CDCC）was used to measure and mental development index（MDI）and motor development index（PDI）at 3 and 6 months. Results：The MDI for the two groups were 73. 2 ± 11. 2 and 80. 7 ± 10. 3,respectively. The PDI for the two groups were 77. 2 ± 93 and 84. 5 ± 10. 2,respectively. The values of MDI and PDI in the observation groups were significantly（p 〈 0. 05）grea-ter than that of the control group. Conclusions：The mild hypothermia therapy after birth of 6 ~ 12 h had a neuroprotective effect on hypoxic - ischemic encephalopathy of neonates.