不同方式亚低温治疗中-重度新生儿缺氧缺血性脑病的临床观察

Mild hypothermia treatment on moderate to severe neonatal hypoxic ischemic encephalopathy

目的:探讨不同方式亚低温治疗中-重度新生儿缺氧缺血性脑病的疗效。方法:收治中-重度新生儿缺氧缺血性脑病患儿50例,随机分为头部亚低温治疗组和全身亚低温治疗组,各25例。两组患儿均在生后6 h内给予不同方式亚低温治疗。结果:与选择性头部亚低温组比较,全身亚低温治疗组治疗后心率减慢(P<0.05);头部亚低温治疗组NBNA测定值明显高于对照组(P<0.05);3、6个月时,头部亚低温治疗组智能发育指数和运动发育指数均明显高于全身亚低温治疗组(P<0.05)。结论:选择性头部亚低温治疗对中-重度新生儿缺氧缺血性脑病近期和远期神经保护作用明显优于全身亚低温治疗。

Objective:To explore the effect of mild hypothermia therapy on moderate to severe neonatal hypoxic-ischemic encephalopathy.Methods:50 children with moderate to severe hypoxic ischemic encephalopathy were randomly divided into the head mild hypothermia treatment group and total body mild hypothermia treatment group,with 25 cases in each group.The two groups were treated with different hypothermia treatments within 6 h after birth.Results:Compared with the selective mild hypothermia group,the heart rate of the whole body mild hypothermia group was slower(P<0.05),and the value of NBNA in the head mild hypothermia treatment group was significantly higher than that of the control group(P<0.05).The intelligence development index and the motor development index of the head mild hypothermia treatment group were significantly higher than those in the control groupat 3 months and 6 months(P<0.05).Conclusion:The short-term and long-term neuroprotective effect of selective head mild hypothermia on hypoxic-ischemic encephalopathy in moderate to severe neonates is better than that of systemic hypothermia.