头部亚低温不同治疗时间对新生儿中重度缺氧缺血性脑病的疗效观察

Efficacy of different head hypothermia treatment time on the treatment of neonatal moderate to severe hypoxic ischemic encephalophy

目的：探讨选择性头部亚低温治疗不同持续时间对中重度新生儿缺氧缺血性脑病的期疗效及安全性。方法：中重度新生儿缺氧缺血性脑病患儿106例,根据治疗方法分为对照组、48h组、72h组、96h组,对照组维持肛温36.7℃-37.5℃,其他组在出生后6h内予选择性头部亚低温治疗,治疗时间分别持续48h、72h及96h。28d后采用NBNA评分对四组患儿行20项新生儿行为神经测定,并记录治疗期间不良反应。结果：72h组和96h组患儿NBNA评分较48h组和对照组高,差异有统计学意义（P〈0.05）;72h组和96h组患儿NBNA评分、48h组和对照组患儿NBNA评分,差异无统计学意义（P〉0.05）;96h组不良反应发生率高于48h组和72h组,差异有统计学意义（P〈0.05）,而48h组和72h组不良反应发生率差异无统计学意义（P〉0.05）。结论：选择性头部亚低温持续72h治疗中重度新生儿缺氧缺血性脑病疗效优于48h,但延长低温至96h时可能会增加不良反应的发生。

Objective：To explore the efficacy of different head hypothermia treatment time on the treatment of neonatal moderate to severe hypoxic ischemic encephalophy.Methods：106cases of neonatal moderate to severe hypoxic ischemic encephalophy were selected and divided into a control group,a 48-hour group,a 72-hour group,and a 96-hour group.In the control group,the rectum temperature was maintained at 36.7℃to 37.5℃.Patients of the other three groups received head hypothermia treatment within 6hours,and the duration for each group was 48 h,72-hour,and 96 hrespectively.After 28day＇s treatment,the patients took NBNA and the adverse effects were recorded.Results：NANA scores in the 72-hour group and 96-hour group were higher than that in the control group and the48-hour group,and the differences were statistically significant（P〈0.05）.There was no statistical significance of NANA scores between the 72-hour group,the 96-hour group,the 48-hour group and the control group（P〈0.05）.There was statistical significance of adverse reaction rate：the rate in the 96-hour group was higher than that of the48 hgroup and the 72-hour group（P〈0.05）.There was no statistical significance of adverse reaction rate between the48-hour group and the 72-hour group（P〉0.05）.Conclusion：The efficacy of head hypothermia treatment in 72 hours was superior to that in 48 hours.However,duration extended to 96 hours will increase the adverse reaction rate.