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目的探讨应用选择性头部亚低温治疗新生儿缺氧缺血性脑病(HIE)的临床效果。方法 46例HIE足月儿为临床研究对象,随机将患儿分为亚低温治疗组及对照组,每组23例。对两组患儿采取维持血压、血氧饱和度、灌注及血糖等内环境稳定,通气、止惊、降低颅压及消除脑干症状等措施治疗,治疗组患儿在出生6 h内加用选择性头部亚低温进行治疗,72 h内对患儿进行脑部复温。观察两组HIE治疗前、治疗6、24、48、72 h神经症状发生率、呼吸、心率、血压、血氧饱和度及生化变化。结果治疗组24、48、72 h心率较治疗前下降(P<0.05)。两组呼吸频率、血压、血氧饱和度比较差异无统计学意义(P>0.05),治疗后血气分析变化差异有统计学意义(P<0.05),两组血糖、肾肝功、凝血功能及电解质变化差异无统计学意义(P>0.05)。治疗后,两组神经系统症状及体征变化差异有统计学意义(P<0.05)。结论对HIE新生儿应用选择性头部亚低温治疗是安全有效的,对HIE近期效果显著。
Objective To investigate the clinical effect of selective head hypothermia on neonatal hypoxic-ischemic encephalopathy (HIE). Methods Forty - six HIE term infants were randomly divided into mild hypothermia group and control group, with 23 cases in each group. The two groups of children to maintain blood pressure, oxygen saturation, perfusion and blood glucose and other environmental stability, ventilation, only shock, reduce intracranial pressure and eliminate symptoms such as brain stem treatment, the treatment group of children within 6 h after birth plus Selective head mild hypothermia for treatment, 72 h in children with brain rewarming. The incidence of neurological symptoms, respiration, heart rate, blood pressure, blood oxygen saturation and biochemical changes were observed before treatment, 6,24,48 and 72 h after HIE treatment. Results The heart rate of the treatment group decreased 24, 48 and 72 h after treatment (P <0.05). There was no significant difference in respiratory rate, blood pressure and oxygen saturation between the two groups (P> 0.05), and there was significant difference between the two groups in blood gas analysis (P <0.05). The blood sugar, kidney and liver function, There was no significant difference in electrolytes (P> 0.05). After treatment, there were significant differences in neurological symptoms and signs between the two groups (P <0.05). Conclusions It is safe and effective to apply selective head mild hypothermia to neonates with HIE, and the effect on HIE in the near future is significant.