新生儿缺氧缺血性脑病后亚低温时代管理新思考

New thoughts on neonatal hypoxic-ischemic encephalopathy in post-cooling era

新生儿缺氧缺血性脑病过去二十年经历了前亚低温支持治疗时代,作为唯一有效的治疗措施,现已从标准亚低温时代演变为后亚低温治疗时代。后亚低温时代新生儿缺氧缺血性脑病治疗以优化亚低温治疗目标患儿的选择和优化现有低温治疗方法为目标;同时为进一步降低中、重度缺氧缺血性脑病患儿的死亡和伤残率,应开展亚低温叠加新的有潜质神经保护剂的深入研究。

Management of the neonatal hypoxic-ischemic encephalopathy(HIE)has been evolving from a pre-cooling era with supportive therapy to standardized cooling era and currently to a post-cooling era over the last two decades.To further decrease the mortality and morbidity of HIE in post-cooling era,we need to focus on the selection of HIE patients who may benefit from cooling and optimization of the available cooling approaches,and to identify research gaps with regard to therapeutic strategies such as combining cooling with promising neuroprotective agents.