Efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy:a prospective randomized controlled study
10.7499/j.issn.1008-8830.2401031
- VernacularTitle:新生儿轻度缺氧缺血性脑病亚低温治疗效果的前瞻性随机对照研究
- Author:
Jie HUANG
1
;
Ya-Ling DING
;
Liang GAO
;
Yao ZHU
;
Ya-Yin LIN
;
Xin-Zhu LIN
Author Information
1. 厦门大学附属妇女儿童医院/厦门市妇幼保健院新生儿科/厦门市围产-新生儿感染重点实验室/厦门市围产医学临床研究中心,福建厦门 361003
- Keywords:
Hypoxic-ischemic encephalopathy;
Therapeutic hypothermia;
Brain magnetic resonance imaging;
Brain injury;
Neonate
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(8):803-810
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy(HIE).Methods A prospective study was performed on 153 neonates with mild HIE who were born from September 2019 to September 2023.These neonates were randomly divided into two groups:therapeutic hypothermia(n=77)and non-therapeutic hypothermia group(n=76).The short-term clinical efficacy of the two groups were compared.Barkovich scoring system was used to analyze the severity of brain injury shown on magnetic resonance imaging(MRI)between the two groups.Results There were no significant differences in gestational age,gender,birth weight,mode of birth,and Apgar score between the therapeutic hypothermia and non-therapeutic hypothermia groups(P>0.05).There were no significant differences in the incidence rates of sepsis,arrhythmia,persistent pulmonary hypertension and pulmonary hemorrhage and the duration of mechanical ventilation within the first 72 hours after birth between the two groups.The therapeutic hypothermia group had longer prothrombin time within the first 72 hours after birth and a longer hospital stay(P<0.05).Compared with the non-therapeutic hypothermia group,the therapeutic hypothermia group had lower incidence rates of MRI abnormalities(30%vs 57%),moderate to severe brain injury on MRI(5%vs 28%),and watershed injury(27%vs 51%)(P<0.05),as well as lower medium watershed injury score(0 vs 1)(P<0.05).Conclusions Therapeutic hypothermia can reduce the incidence rates of MRI abnormalities and watershed injury,without obvious adverse effects,in neonates with mild HIE,suggesting that therapeutic hypothermia may be beneficial in neuroprotection in these neonates.
