选择性头部亚低温治疗新生儿缺氧缺血性脑病

目的探讨选择性头部亚低温对新生儿缺氧缺血性脑病（HIE）的疗效。方法50例中、重度HIE新生儿随机分为治疗组和对照组各25例。对照组予对症支持治疗，治疗组在此基础上予选择性头部亚低温，持续72h。观察治疗后二组头颅B超大脑中动脉阻力指数（RI）和生后5—7d及28dNBNA评分。结果治疗组与对照组比较总有效率48％（12／25例）vs28％（7／25例），中度HIE有效率68．75％（11／16例）vs41．18％（7／17例），重度HIE有效率11．11％（1／9例）vs0。生后3—4d头颅B超大脑中动脉RI〈0．55的患儿，治疗组与对照组比较总有效率13．33％（2／15例）vs0，R10．55～0．80的总有效率100％（10／10例）vs58．33％（7／12例）。结论选择性头部亚低温做为一种脑保护治疗可被用来治疗新生儿HIE；亚低温对中度HIE治疗可能有效。

Clinical Observations of Selective Head Mild Hypothermia on Neonatal Hypoxic-Ischemic Encephalopathy

Objective To explore the effects of selective head mild hypothermia on neonatal hypoxic-ischemic encephalopathy(HIE).Methods Fifty neonates with moderate or severe HIE were randomly assigned into treatment group(n=25) and control group(n=25).The control group got routine treatment.In addition to the routine treatment,the treatment group received selective head mild hypothermia treatment for 72 hours.In both groups patients of cerebral middle artery resistance index(RI) at postnatal age 3-4 days and neonatal behavioral neurological assessment(NBNA) score at 5-7 days and 28 days of life were determined.Results Compared with control group,the total cure rate of treatment group was 48%(12/25 cases) vs 28%(7/25 cases).The cure rate of moderate HIE was 68.75%(11/16 case) vs 41.18%(7/17 cases).The cure rate of severe HIE was 11.11%(1/9 case) vs 0(0 case).The total cure rate of cerebral middle artery RI<0.55 of patients was 13.33%(2/15 cases) vs 0(0 case) and the total cure rate of cerebral middle artery RI 0.55-0.80 of patients at postnatal age 3-4 days was 100%(10/10 cases) vs 58.33%(7/12 cases).Conclusions Selective head mild hypothermia treatment may be used as a neuroprotective therapy in treating neonates with HIE.It may effective the treatment of moderate HIE with head mild hypothermia treatment.