亚低温治疗新生儿重度窒息的疗效和安全性观察

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亚低温治疗新生儿重度窒息的疗效和安全性观察

作者:朱亚平

来源:《中国现代医生》2012年第25期

[摘要] 目的 探讨亚低温治疗新生儿重度窒息的疗效和临床安全性。 方法 将51例重度窒息新生儿按序贯试验分为治疗组(n = 26)和对照组(n = 25)。对照组采用常规治疗;治疗组在常规治疗的基础上给予选择性头部降温72 h。进行两组患儿出生后10 d EEG分级、治疗72 h血清肌酸激酶同工酶(CK—MB)和乳酸脱氢酶(LDH)水平检测,并记录治疗72 h和复温48 h的心率、呼吸和血压。 结果 治疗组10 d EEG分级明显优于对照组(P < 0.05)。治疗72 h两组血清CK—MB和LDH水平较治疗前均降低,治疗组血清CK—MB和LDH下降较对照组更为显著(均P < 0.05)。治疗72 h,治疗组除心率明显低于对照组外(P < 0.05),呼吸、收缩压和舒张压均与对照组差异不明显(P > 0.05),并且治疗组患儿复温48 h后,以上各指标均与对照组的差异无统计学意义(P > 0.05)。 结论 选择性头部降温亚低温治疗可以提高重度窒息新生儿的疗效,并初步验证了其临床安全性。 [关键词] 亚低温;新生儿窒息;疗效;安全性

[中图分类号] R722.12 [文献标识码] B [文章编号] 1673—9701(2012)25—0033—02 Studies on efficacy and safety of mild hypothermia for neonatal severe asphyxia ZHU Yaping

Department of Neonatology, Maternal and Child Health Hospital of Jingdezhen City in Jiangxi Province, Jingdezhen 333000, China

[Abstract] Objective To explore efficacy and safety of treatment with mild hypothermia for

neonatal severe asphyxia. Methods Fifty—one severe asphyxia newborns were divided into treatment group (26 cases) and control group (25 cases) with sequential trial. Patients in control group were carried out conventional therapy, and treatment group was given selective head cooling on basis of conventional therapy. The indicators of EEG classification, CK—MB and LDH were detected. Heart rate, respiration and blood pressure were recorded. Results EEG classification at 10th day of the treatment group was significantly better than control group (P < 0.05). Serum CK—MB and LDH levels of two groups were significantly lower than before treatment (P < 0.05). Compared with control group, serum CK—MB and LDH levels of treatment group decreased significantly (P < 0.05). Heart rate of treatment group were significantly lower than control group at treatment of 72 h (P < 0.05). The differences of heart rate, respiration and blood pressure were not significant between two groups at rewarming of 48h (P > 0.05). Conclusion The mild

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