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足月和早产儿缺氧缺血性脑病(HIE)。

Hypoxic Ischemic Encephalopathy (HIE) in Term and Preterm Infants.

机构信息

University Clinic for Gynecology and Obstetrics, Medical Faculty Skopje, RN Macedonia.

Institute for Epidemiology and Medical Statistics, Medical Faculty Skopje, RN Macedonia.

出版信息

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2022 Apr 22;43(1):77-84. doi: 10.2478/prilozi-2022-0013.

Abstract

Hypoxic-ischemic syndrome (HIS) and Hypoxic-ischemic encephalopathy (HIE) are conditions that affect term and premature babies, with different pathophysiology and different brain disorders. HIE appears in 1-6 / 1000 live births and 26/1000 live births in developing countries. 15-20% die in the early neonatal period, while surviving babies have severe neurological impairment, including cerebral palsy, epilepsy, visual and hearing impairment, cognitive impairment, intellectual, behavioural, and social disorders. The hypoxic-ischemic event occurs before, during or after birth. The reasons may be related to the mother, the way of birth, the placenta, and the newborn. The criteria for diagnosis of HIE include a combination of perinatal factors, the need for resuscitation, standard neurological examinations, neurophysiological monitoring, neuroimaging methods and biochemical markers. The most effective treatment for HIE is hypothermia in combination with pharmacological therapy. HIE and HIS are problem that still persist in developing countries due to inadequate obstetric care, neonatal resuscitation, and hypothermia. Current and emerging research for HIE examines new markers for early recognition, treatment, and appropriate neuroprotection of high-risk term and premature infants.

摘要

缺氧缺血性综合征 (HIS) 和缺氧缺血性脑病 (HIE) 是影响足月和早产儿的疾病,具有不同的病理生理学和不同的脑部疾病。HIE 出现在 1-6/1000 例活产儿和发展中国家的 26/1000 例活产儿中。15-20%的新生儿在早期死亡,而幸存的婴儿有严重的神经功能障碍,包括脑瘫、癫痫、视力和听力障碍、认知障碍、智力、行为和社会障碍。缺氧缺血事件发生在出生前、出生时或出生后。原因可能与母亲、分娩方式、胎盘和新生儿有关。HIE 的诊断标准包括围产期因素的组合、需要复苏、标准的神经检查、神经生理学监测、神经影像学方法和生化标志物。HIE 最有效的治疗方法是低温联合药物治疗。由于产科护理、新生儿复苏和低温治疗不足,HIE 和 HIS 仍然是发展中国家存在的问题。目前和新兴的 HIE 研究检查了高危足月和早产儿早期识别、治疗和适当神经保护的新标志物。

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