Department of Neonatology, Wilhelmina Children's Hospital, UMC, Utrecht, The Netherlands.
Semin Pediatr Neurol. 2009 Dec;16(4):216-25. doi: 10.1016/j.spen.2009.09.001.
Our aim was to document changes in the evaluation and prognosis of term-born infants with neonatal encephalopathy of hypoxic-ischemic origin, with particular reference to our own experiences and influences, and to summarize the debate on causation and the relative importance of antenatal and perinatal factors. High quality neonatal cranial ultrasound and magnetic resonance imaging and spectroscopy have enabled the accurate early visualization of different patterns of hypoxic-ischemic brain injury and prediction of their associated outcomes. Long-term follow-up shows that cognitive and memory difficulties may follow even in children without motor deficits. The very early use of electrophysiologic methods has allowed broad prognostic categorization of infants when this is not possible from clinical assessment or imaging, providing a rationale for entry into intervention trials, such as therapeutic hypothermia. This work has also shown that most of these infants have evidence of acute hypoxic-ischemic brain injury that explains their symptoms and outcomes.
我们的目的是记录具有缺氧缺血性来源的足月新生儿脑病的评估和预后的变化，特别提到我们自己的经验和影响，并总结关于病因和产前及围产期因素相对重要性的争论。高质量的新生儿头颅超声和磁共振成像和波谱分析能够准确地早期显示不同类型的缺氧缺血性脑损伤，并预测其相关结局。长期随访表明，即使在没有运动缺陷的儿童中，也可能出现认知和记忆困难。非常早期使用电生理方法可以在临床评估或影像学检查不可行时对婴儿进行广泛的预后分类，为进入干预试验（如治疗性低温）提供了依据。这项工作还表明，这些婴儿中的大多数都有急性缺氧缺血性脑损伤的证据，这可以解释他们的症状和结局。
