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【目的】观察全身亚低温治疗新生儿缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)对内环境的影响,为临床治疗提供参考依据。【方法】将本院收治的29例HIE患儿随机分为治疗组(15例)和对照组(14例),对照组采用常规治疗,治疗组在常规治疗的基础上结合全身亚低温治疗。所有患儿于入院后0、72h检测血电解质、肝功能、肾功能和心肌酶谱、血气分析。【结果】两组患儿入院时两组患儿血电解质、肝肾心功能、PH值及BE浓度差异均无统计学意义。入院后72h治疗组Ca2+、Na+浓度均高于对照组,CK-MB浓度低于对照组,差异有统计学意义(P<0.05);两组患儿Cl-、K+、ALT、AST、BUN、Cr、BE浓度及PH值比较差异均无统计学意义(P>0.05)。【结论】亚低温治疗能改善患儿的低钙血症、低钠血症,未加重肝肾功能损害、酸碱平衡紊乱,且可能对受损心肌有一定的保护作用。
【Objective】 To observe the effect of systemic mild hypothermia on neonatal hypoxic ischemic encephalopathy (HIE) on the internal environment and provide a reference for clinical treatment. 【Methods】 Thirty-nine HIE children admitted to our hospital were randomly divided into treatment group (n = 15) and control group (n = 14). The control group was treated with conventional therapy. The treatment group was treated with systemic hypothermia on the basis of routine treatment. All children were tested for blood electrolytes, liver function, renal function and myocardial enzymes, blood gas analysis at 0 and 72 hours after admission. 【Results】 There was no significant difference in blood electrolytes, liver and kidney function, PH value and BE concentration between the two groups on admission. The concentrations of Ca2 + and Na + in the treatment group at 72h after admission were higher than those in the control group, and the CK-MB concentrations were lower than those in the control group (P <0.05). The levels of Cl-, K +, ALT, AST, BUN, Cr, BE concentrations and PH values were no significant difference (P> 0.05). 【Conclusion】 Mild hypothermia can improve children’s hypocalcemia, hyponatremia, liver and kidney dysfunction, acid-base balance disorders, and may have some protective effect on the damaged myocardium.