在足月新生儿轻度新生儿脑病中，是否有应用治疗性低温的作用？
Is there a role for therapeutic hypothermia administration in term infants with mild neonatal encephalopathy?
机构信息
Department of Pediatrics Division of Newborn Medicine, Weill Cornell Medicine, NewYork Presbyterian Komansky Children's Hospital, 525 East 68th Street, New York, NY, 10065, USA.
出版信息
J Perinatol. 2020 Mar;40(3):522-529. doi: 10.1038/s41372-019-0562-z. Epub 2019 Nov 25.
OBJECTIVE
Identifying term infants presenting with early mild neonatal encephalopathy (NE) as candidates for therapeutic hypothermia (TH) remains unclear. Study objectives were to characterize the neonatal clinical, magnetic resonance imaging (MRI), and longer-term outcome in infants with mild NE treated with TH.
STUDY DESIGN
Retrospective cohort study of infants admitted with mild or moderate NE treated with TH. Enrollment criteria included a sentinel event, severe acidosis, DR interventions, and low Apgar scores.
RESULTS
Infants with mild (n = 11) and moderate NE (n = 37) received TH. Mild NE findings included hyperalertness (64%), hypotonia (73%), high level sensory response (91%); 64% progressed to moderate NE. Infants with mild vs. moderate NE had less severe MRI changes (0 vs. 16%) and no cerebral palsy (CP) (0 vs. 13%).
CONCLUSIONS
Outcomes were favorable with mild NE whereas four infants with moderate NE developed CP. A potential role for TH in this population requires further study.
目的
确定早期轻度新生儿脑病（NE）患儿是否适合接受治疗性低温（TH）治疗仍不明确。本研究旨在描述接受 TH 治疗的轻度 NE 患儿的新生儿临床、磁共振成像（MRI）和长期结局特征。
研究设计
对接受 TH 治疗的轻度或中度 NE 患儿进行回顾性队列研究。纳入标准包括出现首发事件、严重酸中毒、DR 干预和低 Apgar 评分。
结果
11 例轻度 NE 和 37 例中度 NE 患儿接受了 TH 治疗。轻度 NE 的表现包括警觉过度（64%）、肌张力低下（73%）、高级感觉反应（91%）；64%进展为中度 NE。轻度 NE 患儿的 MRI 改变程度较轻（0% vs. 16%），无脑瘫（CP）（0% vs. 13%）。
结论
轻度 NE 患儿的结局良好，而 4 例中度 NE 患儿发展为 CP。TH 在该人群中的潜在作用需要进一步研究。
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