Zhang Peng, Cheng Guo-Qiang
Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2013 Oct;15(10):918-22.
Randomized controlled trials have demonstrated the safety and efficacy of mild hypothermia in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE), which can reduce mortality or the incidence of severe neurological sequelae. Mild hypothermia has been used in the neonatal intensive care unit (NICU) as a routine treatment method for neonatal HIE in many developed countries, and it is increasingly applied in some NICUs in China. However, 40%-50% of the neonates treated with mild hypothermia die or develop severe neurological disability. Thus, to achieve the best neuroprotective effect, issues such as selection of patients with indications for mild hypothermia, cooling method, optimal time for mild hypothermia, duration of mild hypothermia, optimal target temperature, and the safety and long-term effects of mild hypothermia combined with other therapies, need to be further discussed. This article reviews the latest progress in clinical research on these issues.
随机对照试验已证明亚低温治疗新生儿缺氧缺血性脑病(HIE)的安全性和有效性,亚低温可降低死亡率或严重神经后遗症的发生率。在许多发达国家,亚低温已在新生儿重症监护病房(NICU)中作为新生儿HIE的常规治疗方法使用,并且在中国的一些NICU中应用也越来越多。然而,接受亚低温治疗的新生儿中有40%-50%死亡或出现严重神经功能障碍。因此,为了实现最佳的神经保护效果,诸如亚低温适应证患者的选择、降温方法、亚低温的最佳时机、亚低温持续时间、最佳目标温度以及亚低温与其他疗法联合应用的安全性和长期效果等问题,仍需进一步探讨。本文综述了这些问题的临床研究最新进展。