治疗性浅低温在新生儿中重度缺氧缺血性脑病中的研究进展

Research progress of mild therapeutic hypothermia in neonatal moderate to severe hypoxic-ischemic en⁃cephalopathy

新生儿缺氧缺血性脑病是指围产期窒息所引起的脑损伤,严重者可致死亡和永久性的神经功能损害。治疗性浅低温可减少患有中重度缺氧缺血性脑病的足月和近足月婴儿的死亡或残疾。最新的临床和实验研究进一步完善了低温疗法的关键参数,包括启动低温疗法的时机、降温深度、持续时间,随后的复温速率以及预防分娩和复苏过程中的发热。改善神经发育结局的关键是出生后早期诊断和启动低温疗法。本文将对治疗性浅低温在新生儿中重度缺氧缺血性脑病中的研究进展做一综述,并介绍常用的低温诱导方法、临床上面临的挑战和未来发展方向。

Neonatal hypoxic-ischemic encephalopathy refers to brain damage caused by perinatal asphyxia,which can cause death and permanent neurological impairment in severe cases.Therapeutic hypothermia reduces death or disability in term and near-term infants with moderate to severe hypoxic-ischaemic encephalopathy.The latest studies have further refined the key parameters of hypothermia,including the timing,depth of cooling,duration,subsequent rate of rewarming,and prevention of fever during delivery and resuscitation.The key to improving neurodevelopmental outcomes is early postnatal diagnosis and initiation of hypothermia.This article will review the research progress of mild therapeutic hypothermia in neonatal hypoxic-ischemic encephalopathy,and introduce commonly used hypothermia induction methods,clinical challenges and future development directions.