Degos Vincent, Loron Gauthier, Mantz Jean, Gressens Pierre
Inserm, U676, Paris, France.
Anesth Analg. 2008 Jun;106(6):1670-80. doi: 10.1213/ane.0b013e3181733f6f.
Injury to the perinatal brain is a leading cause of childhood mortality and lifelong disability. Cerebral palsy and cognitive impairment are usually related to periventricular white matter damage, which is seen chiefly in babies born before 32 wk gestational age, and to corticosubcortical lesions, which occur mainly in full-term infants. Despite recent improvements in neonatal care, no effective treatment for perinatal brain lesions is available. Several interventions, such as magnesium sulfate in preterm newborns and hypothermia in term newborns, are the focus of completed or continuing clinical trials. Improved understanding of the pathophysiological mechanisms involved in perinatal brain lesions helps to identify potential targets for neuroprotective interventions, as discussed in this review.
围产期脑损伤是儿童期死亡和终身残疾的主要原因。脑瘫和认知障碍通常与脑室周围白质损伤有关，这种损伤主要见于孕龄32周前出生的婴儿，也与皮质下皮质病变有关，后者主要发生在足月儿。尽管近年来新生儿护理有所改善，但尚无针对围产期脑损伤的有效治疗方法。几种干预措施，如早产新生儿使用硫酸镁和足月新生儿进行低温治疗，是已完成或正在进行的临床试验的重点。如本综述所述，对围产期脑损伤所涉及的病理生理机制的进一步了解有助于确定神经保护干预的潜在靶点。
