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治疗性低温作为围产期窒息新生儿的神经保护策略——病例报告

Therapeutic hypothermia as a neuroprotective strategy in newborns with perinatal asphyxia-case report.

作者信息

de Oliveira Nayara Rodrigues Gomes, Teixeira Gustavo Gonçalves, Fernandes Kathlen Terezinha Montes Soares, Avelar Marla Moreira, Medeiros Maja, Formiga Cibelle Kayenne Martins Roberto

机构信息

Department of Physiotherapy, State University of Goiás-UEG, Goiânia, Brazil.

Department of Medicine, Hospital das Clínicas, Federal University of Goiás-UFG, Goiânia, Brazil.

出版信息

Front Rehabil Sci. 2023 Apr 19;4:1132779. doi: 10.3389/fresc.2023.1132779. eCollection 2023.

Abstract

BACKGROUND

Perinatal asphyxia is a public health problem and the third major cause of death among children under 5 years.

OBJECTIVE

Two clinical cases of newborns with perinatal asphyxia submitted to therapeutic hypothermia and the follow-up of their motor development after hospital discharge have been reported.

METHODS

This retrospective case report study included two newborns with hypoxic-ischemic encephalopathy due to perinatal asphyxia who received a hypothermia protocol at the neonatal intensive care unit (NICU). The two newborns and their families were followed up at the outpatient clinic and assessed using the Hammersmith Child Neurological Examination, Alberta Child Motor Scale, and Denver Developmental Screening Test-II.

RESULTS

The newborns were submitted to a 72-hour hypothermia protocol. One newborn remained for 13 days in the NICU, while the other remained for 22 days. According to the multidisciplinary team, both cases presented with typical motor development with no cerebral palsy during the follow-up.

CONCLUSION

Both cases showed positive results and a good prognostic for motor development. Therapeutic hypothermia may be a strategy to prevent neurologic sequelae in newborns with perinatal asphyxia, including cerebral palsy.

摘要

背景

围产期窒息是一个公共卫生问题,也是5岁以下儿童死亡的第三大主要原因。

目的

报告两例围产期窒息新生儿接受治疗性低温治疗及出院后运动发育随访的临床病例。

方法

这项回顾性病例报告研究纳入了两名因围产期窒息导致缺氧缺血性脑病的新生儿,他们在新生儿重症监护病房(NICU)接受了低温治疗方案。对这两名新生儿及其家庭进行门诊随访,并使用哈默史密斯儿童神经学检查、艾伯塔儿童运动量表和丹佛发育筛查测试-II进行评估。

结果

新生儿接受了72小时的低温治疗方案。一名新生儿在NICU住院13天,另一名住院22天。根据多学科团队的评估,在随访期间,两例患儿均表现出典型的运动发育,无脑瘫。

结论

两例患儿均取得了积极的结果,运动发育预后良好。治疗性低温可能是预防围产期窒息新生儿神经后遗症(包括脑瘫)的一种策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/780c/10154559/263bbca68369/fresc-04-1132779-g001.jpg

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