Department of Neonatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201600, China.
Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 200032, China.
BMC Pediatr. 2023 Oct 26;23(1):530. doi: 10.1186/s12887-023-04365-8.
Though there has been an increase in the number of neonates with hypoxic-ischemic encephalopathy (HIE) treated by therapeutic hypothermia (TH) in recent years, the effect of therapeutic hypothermia on mild HIE neonates is still uncertain.
This study aims to explore the safety and efficacy of therapeutic hypothermia in neonates with mild HIE.
Retrospectively collected between January 2010 to December 2022 at Children's Hospital of Fudan University, neonates with mild HIE were divided into TH and non-TH groups. Clinical data of the mild HIE neonates and their mothers' general information during pregnancy were collected. SPSS 23.0 was used to compare the general condition, the incidence of adverse events, and efficacy in the two groups.
A total of 71 neonates with mild HIE were included, including 31 in the TH group and 40 in the non-TH group. Compared with the non-TH group, the TH group had significantly lower 5-minute Apgar scores [6 (5-7) points vs. 7 (5-8) points, p = 0.033 ], but a higher rate of tracheal intubation at birth (68%, 21/31 vs. 40%, 16/40, p = 0.02), a higher rate of chest compressions > 30 s (39%, 12/31 vs. 15%, 6/40, p = 0.023), the later initiation enteral feeding [4 (3-4) days vs. 1 (1-2) days, p < 0.001], a higher usage rate of analgesic and sedative drugs (45%, 14/31 vs. 18%, 7/40, p = 0.011) and the longer hospital stay [12.5 (11-14) days vs. 9 (7-13.9) days, p = 0.003]. There was no death in 71 mild HIE neonates. TH group had lower incidence of brain injury (16%, 5/31 vs. 43%, 17/40, p = 0.017) and encephalopathy progression (10%, 3/31 vs. 45%, 18/40, p = 0.001) than the non-TH group. There was no statistical significance in the incidence of adverse events between the two groups.
Therapeutic hypothermia can reduce the incidence of brain injury in neonates with mild HIE.
近年来，接受治疗性低温（therapeutic hypothermia，TH）治疗的缺氧缺血性脑病（hypoxic-ischemic encephalopathy，HIE）新生儿数量有所增加，但 TH 对轻度 HIE 新生儿的疗效仍不确定。
本研究旨在探讨 TH 治疗轻度 HIE 新生儿的安全性和有效性。
回顾性收集 2010 年 1 月至 2022 年 12 月复旦大学附属儿科医院收治的轻度 HIE 新生儿的临床资料，根据是否行 TH 治疗分为 TH 组和非 TH 组。收集轻度 HIE 新生儿及其母亲的一般信息。采用 SPSS 23.0 软件比较两组新生儿的一般情况、不良事件发生率及疗效。
共纳入 71 例轻度 HIE 新生儿，其中 TH 组 31 例，非 TH 组 40 例。与非 TH 组比较，TH 组新生儿出生 5 分钟时 Apgar 评分较低[6（5～7）分比 7（5～8）分，p=0.033]，但气管插管率较高[68%（21/31）比 40%（16/40），p=0.02]，胸外按压时间＞30 s 比例较高[39%（12/31）比 15%（6/40），p=0.023]，开始肠内喂养时间较晚[4（3～4）天比 1（1～2）天，p＜0.001]，镇痛镇静药物使用率较高[45%（14/31）比 18%（7/40），p=0.011]，住院时间较长[12.5（11～14）天比 9（7～13.9）天，p=0.003]。71 例轻度 HIE 新生儿均存活。TH 组脑损伤发生率较低[16%（5/31）比 43%（17/40），p=0.017]，脑病进展发生率较低[10%（3/31）比 45%（18/40），p=0.001]。两组不良事件发生率比较，差异无统计学意义。
TH 可降低轻度 HIE 新生儿脑损伤的发生率。
Zotero 插件
