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研究

目的：探讨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（HIE）的影响。方法：选取2008年7月-2012年11月本院确诊治疗的中重度HIE患儿123例,按随机数字表法分为早期组、中期组、晚期组,三组均给予头部亚低温治疗,早期组为出生后4 h内,中期组为出生后4-8 h内,晚期组为出生后8 h后。对患儿采用神经行为测定（NBNA）、标准化贝利婴儿（MDI、PDI）进行评估,分析对比各组患儿的疗效和预后情况。结果：早期组、中期组、晚期组患儿身高、体重增量基本一致,差异均无统计学意义（P〉0.05）;中期组患儿NBNA、MDI、PDI评分均高于早期组,早期组NBNA、MDI,PDI评分均高于晚期组,差异有统计学意义（P〈0.05）;中期组患儿伤残率、死亡率均低于早期组,早期组患儿伤残率、死亡率均低于晚期组,差异均有统计学意义（P〈0.05）。结论：头部亚低温不同治疗时机对中重度缺氧缺血性脑病新生儿机体发育无不良影响,中期治疗可有效提高患儿疗效,值得临床作进一步推广。

The Effect of Different Head Hypothermia Treatment Time on the Influence of Neonatal Moderately Severe Hypoxic Ischemic Encephalopathy

Objective：To discuss the effect of different head hypothermia treatment time on the influence of neonatal moderately severe HIE.Method：123 newborn child with HIE were selected from July 2008 to November 2012 in our hospital.According to the random distribution, all children were divided into the early group,the middle group,the late group,all the groups were given the head of the cryogenic treatment, the early group set in the 4 h after birth,the middle group set in the 4-8 h after birth,the late group set after birth for 8 h.Determination of nerve（NBNA）,Bayley baby development scale（MDI,PDI）were evaluated in newborn child,the curative effect and prognosis were also analysed.Result：Height,weight increment in the three groups was basically the same（P〉0.05）.NBNA, MDI and PDI score in the middle group were higher than the early group, the score in these group were all higher than the late group, the difference was statistically significant（P〈0.05）.The disability rate,mortality rate in middle group with were lower than the early group,these indicators in the early group were lower than the late group（P〈0.05）.Conclusion：Head hypothermia treatment on HIE in newborn child is not accompacied with adverse effect on the body development, middle treatment can improve newborn child curative effect,it＇s worth for further clinical promotion.