全身亚低温治疗新生儿重度窒息的临床疗效分析

Clinical Efficacy Analysis of Mild Systemic Hypothermia for Neonates with Severe Asphyxia

目的:探讨全身亚低温治疗新生儿重度窒息的临床效果。方法:回顾分析2013年4月-2015年4月本院收治的28例重度窒息的新生儿的治疗情况,根据治疗方式,将患儿分为对照组和低温组,分析两组患儿治疗过程中心率、呼吸及收缩压变化情况,治疗后患儿肝、肾、凝血功能变化情况及治疗后的临床转归情况。结果:两组治疗后呼吸及收缩压与治疗前比较,差异均无统计学意义(P>0.05),治疗后两组心率均低于治疗前,且低温组心率低于对照组,比较差异均有统计学意义(P<0.05);治疗后两组AST、ALT均优于治疗前,且对照组优于低温组,比较差异均有统计学意义(P<0.05);治疗后,两组BUN、Cr、PT及TT均优于治疗前,比较差异均有统计学意义(P<0.05),但两组间BUN、Cr、PT及TT比较,差异均无统计学意义(P>0.05);两组自主吮奶及住院时间比较,差异无统计学意义(P>0.05);低温组NBNA测评得分高于对照组,比较差异有统计学意义(P<0.05)。结论:严密监护下采用亚低温治疗新生儿重度窒息能够有效提高临床疗效及预后,无严重不良反应发生,适合在临床上进一步推广。

Objective： To study the clinical effect of mild systemic hypothermia on newborns with severe asphyxia.Method： The treatment condition of 28 newborns with severe asphyxia in our hospital from April 2013 to April 2015 were retrospectively analyzed.They were divided into control group and hypothermia group according to different treatment methods.The heart rate, breathe and blood pressure of the two groups during therapeutic process were analyzed.The liver function, kidney function, coagulation function after therapy and the clinical outcomes after therapy were also analyzed.Result： The differences in respiratory and blood pressure between before treatmentand after treatment were not statistically significant （ P〉0.05 ） .After treatment, the heart rates of the two groups were lower than before treatment and the heart rate of the hypothcrmia group was lower than that of the control group, the differences were statistically significant （P〈0.05） .After treatment, the ALT and AST of the two groups were all better than those before treatment and the ALT and AST of the control group were better than those of the hypothermia group, the differences were statistically significant （ P〈0.05 ） .After treatment, the BUN, Cr, PT and TT of the two groups were all better than those before treatment, the differences were statistically significant （P〈0.05）, but the differences in BUN, Cr, PT and TT between the two groups were not statistically significant （ P〉0.05 ） .There were no statistically significant differences in independent sucking milk and hospital stay between the two groups （ P〉0.05 ） .The NBNA score of the hypothermia group was higher than that of the control group, the difference was statistically significant （ P〈0.05 ） .Conclusion： Systemic mild hypothermia can effectively improve the clinical efficacy and prognosis of newborns with severe asphyxia under careful monitoring, it has no serious adverse reactions, which is suitable for a further clinical promotion.