接受低温治疗的轻度缺氧缺血性脑病新生儿的特征和短期结局。
Characteristics and short-term outcomes of neonates with mild hypoxic-ischemic encephalopathy treated with hypothermia.
机构信息
Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada.
Department of Pediatrics, McGill University, Montreal, QC, Canada.
出版信息
J Perinatol. 2020 Feb;40(2):275-283. doi: 10.1038/s41372-019-0551-2. Epub 2019 Nov 13.
OBJECTIVE
To compare the characteristics and outcomes of neonates with mild hypoxic-ischemic encephalopathy (HIE) who received hypothermia versus standard care.
STUDY DESIGN
We conducted a retrospective cohort study of neonates ≥35 weeks' gestation and ≥1800 g admitted with a diagnosis of Sarnat stage 1 encephalopathy. We evaluated length of hospital stay, duration of ventilation, evidence of brain injury on MRI, and neonatal morbidities.
RESULTS
Of 1089 eligible neonates, 393 (36%) received hypothermia and 595 (55%) had neuroimaging. The hypothermia group was more likely to be outborn, born via C-section, had lower Apgar scores, and required extensive resuscitation. They had longer durations of stay (9 vs. 6 days, P < 0.001), respiratory support (3 vs. 2 days, P < 0.001), but lower odds of brain injury on MRI (adjusted odds ratio 0.33, 95% CI: 0.22-0.52) compared with standard care group.
CONCLUSION
Despite prolongation of hospital stay, hypothermia may be potentially beneficial in neonates with mild HIE; however, selection bias cannot be ruled out.
目的
比较接受低温治疗与标准治疗的轻度缺氧缺血性脑病（HIE）新生儿的特征和结局。
研究设计
我们对胎龄≥35 周且体重≥1800 克的诊断为 Sarnat 1 期脑病的新生儿进行了回顾性队列研究。我们评估了住院时间、通气时间、MRI 上的脑损伤证据以及新生儿并发症。
结果
在 1089 名符合条件的新生儿中，393 名（36%）接受了低温治疗，595 名（55%）进行了神经影像学检查。低温治疗组更可能是外出分娩、剖宫产分娩、Apgar 评分较低且需要广泛复苏。与标准治疗组相比，低温治疗组的住院时间（9 天 vs. 6 天，P<0.001）和呼吸支持时间（3 天 vs. 2 天，P<0.001）更长，但 MRI 上脑损伤的几率更低（调整后的优势比 0.33，95%CI：0.22-0.52）。
结论
尽管延长了住院时间，但低温治疗可能对轻度 HIE 新生儿有益；然而，不能排除选择偏倚。
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