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[窒息新生儿的低温治疗——匈牙利单中心经验]

[Hypothermia treatment in asphyxiated neonates - a single center experience in Hungary].

作者信息

Kovács Kata, Szakmár Enikő, Méder Ünőke, Kolossváry Márton, Bagyura Zsolt, Lamboy Lilla, Élő Zsuzsanna, Szabó Attila, Szabó Miklós, Jermendy Ágnes

机构信息

I. Gyermekgyógyászati Klinika, Újszülött Intenzív Osztály, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Bókay János u. 53-54., 1083.

MTA-SE "Lendület" Kardiovaszkuláris Képalkotó Kutatócsoport Budapest.

出版信息

Orv Hetil. 2017 Mar;158(9):331-339. doi: 10.1556/650.2017.30661.

Abstract

INTRODUCTION AND AIM

We aimed to analyze patient characteristics of term neonates with hypoxic-ischemic encephalopathy treated with hypothermia at the 3rd level Neonatal Intensive Care Unit of the 1st Department of Pediatrics, Semmelweis University.

METHOD

We conducted a retrospective cohort analysis between 2013-2015, including 97 asphyxiated neonates with HIE who received hypothermia treatment, using our in-house developed novel registry database.

RESULTS

59.8% of neonates were born with Cesarean section and the first blood gas analysis showed a pH of 7.0 ± 0.2, pCO 55.9 ± 27.3 mmHg, base deficit 16.7 ± 7.2 mmol/l, and lactate levels of 13.3 ± 4.7 mmol/l (x ± SD). Hypothermia treatment was started during neonatal transport in 93.7% of the cases, at 2.5 ± 0.3 hours of age. Multiorgan failure associated with the perinatal asphyxia was present in 83.2% of the patients. Patients received intensive therapy for a median of 10.8 days, 61.3% of neonates were discharged home directly, 32.2% required further hospital treatment, and 6.5% died.

CONCLUSION

Our novel registry database allowed for a quick, user-friendly and time-efficient analysis of patient characteristics in neonates with HIE. This registry could aid institutional audit work and prospective clinical data collection. Orv. Hetil., 2017, 158(9), 331-339.

摘要

引言与目的

我们旨在分析在塞梅尔维斯大学第一儿科新生儿重症监护病房接受低温治疗的足月新生儿缺氧缺血性脑病患者的特征。

方法

我们在2013年至2015年间进行了一项回顾性队列分析,使用我们内部开发的新型登记数据库,纳入97例接受低温治疗的窒息性新生儿缺氧缺血性脑病患者。

结果

59.8%的新生儿通过剖宫产出生,首次血气分析显示pH值为7.0±0.2,pCO为55.9±27.3mmHg,碱缺失为16.7±7.2mmol/l,乳酸水平为13.3±4.7mmol/l(x±SD)。93.7%的病例在新生儿转运期间开始低温治疗,年龄为2.5±0.3小时。83.2%的患者存在与围产期窒息相关的多器官功能衰竭。患者接受强化治疗的中位数为10.8天,61.3%的新生儿直接出院回家,32.2%需要进一步住院治疗,6.5%死亡。

结论

我们的新型登记数据库能够快速、方便用户且高效地分析缺氧缺血性脑病新生儿的患者特征。该登记册有助于机构审计工作和前瞻性临床数据收集。《匈牙利医学周报》,2017年,158(9),331 - 339。

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