亚低温治疗新生儿缺氧缺血性脑病临床安全性观察

Clinical Safety Observation of Mild Hypothermia Treatment in Children with Neonatal Hypoxic Ischemic Encephalopathy

目的：对37例亚低温治疗新生儿缺氧缺血性脑病（HIE）进行临床观察,评价亚低温治疗HIE的安全性。方法：将70例诊断为中重度HIE患儿分为治疗组37例和对照组33例,两组均予以对症支持治疗,治疗组同时进行亚低温治疗,维持肛温在33℃～34℃,持续48～72 h,治疗过程中监测患儿心率及呼吸,并监测新生儿治疗前后凝血功能、感染指标。结果：两组均未发生呼吸抑制、心律失常、严重出血,治疗组患儿随着体温下降,心率下降,与对照组比较差异有统计学意义（P〈0.01）;两组患儿在治疗前后呼吸功能、凝血功能、感染指标比较差异均无统计学意义（P〉0.05）。治疗组16.2%患儿出现轻度皮肤硬肿,复温后恢复良好。结论：良好的亚低温管理治疗HIE不会出现严重不良反应,治疗是安全有效的。

Objective： To observe a total of 37 cases of mild hypothermia treatment of neonatal hypoxic ischemic encephalopathy （HIE） in clinical, and evaluate the safety of the treatment of HIE. Methods： Seventy cases diagnosed with moderately severe HIE were divided into treatment group （n = 37 ） and control group （n = 33 ）, both groups were gave symptomatic supported treatment, treatment group was given the mild hypothennia treatment at the same time, maintained anal temperature in 33 ℃～34 ℃, continued 48 - 72 h, monitored children with heart rate and breathing during the process of treatment, and monitored blood coagulation function, infection indexes before and after treatment. Results： Two groups did not have respiratory depression, arrhythmia, severe bleeding. The temperature and heart rate decreased in treatment group, the differences between two groups were statistically significant （P〈0.01）. The breathing, blood coagulation function and infection index in two groups had no statistically significant difference （P〉0.05）. 16.2% cases in treatment group had a mild hard swollen skin, recovered well after thawing. Conclusion： Good mild hypothermia management in the treatment of HIE will not appear serious adverse reaction, treatment is safe and effective.