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目的回顾性分析亚低温治疗新生儿缺氧缺血性脑病的临床资料,探讨亚低温治疗过程中血气、电解质及肾功能及肝功能的变化情况,从而为安全实施亚低温治疗新生儿缺氧缺血性脑病提供借鉴和帮助。方法 15例重度窒息的患儿,按照复旦大学附属儿科医院的亚低温治疗新生儿缺氧缺血性脑病方案(2011),在生后6 h内行亚低温治疗。收集其亚低温治疗前、治疗24、48、72 h血气、电解质、肾功能及肝功能,分析亚低温治疗后新生儿内环境的变化。结果亚低温治疗后K~+、Na~+、Mg~(2+)在亚低温治疗过程中的变化不明显;Ca~(2+)、磷(P)在亚低温治疗过程中的变化有统计学意义;乳酸呈下降趋势,pH、PCO_2、碱剩余(BE)呈上升趋势,治疗前后差异有统计学意义。结论亚低温治疗新生儿缺氧缺血性脑病过程中,仍需动态观察内环境的病理、生理变化并提供适当干预,以便为安全实施亚低温治疗提供保证。
Objective To retrospectively analyze the clinical data of mild hypothermia in neonates with hypoxic-ischemic encephalopathy and to explore the changes of blood gas, electrolytes, renal function and liver function in the process of mild hypothermia, so as to ensure the safe implementation of mild hypothermia in neonates with hypoxia Hematopathy to provide reference and help. Methods Fifteen children with severe asphyxia were treated with mild hypothermia in neonatal hypoxic-ischemic encephalopathy program (2011) at Children’s Hospital of Fudan University. Mild hypothermia was given within 6 hours after birth. Blood gases, electrolytes, renal function and liver function were collected before 24 h, 48 h and 72 h after mild hypothermia treatment, and the changes of neonatal environment after mild hypothermia were analyzed. Results The changes of K ~ +, Na ~ + and Mg ~ (2+) after mild hypothermia treatment did not change obviously in mild hypothermia treatment. The change of Ca ~ (2+) and phosphorus (P) Statistical significance; Lactate showed a downward trend, pH, PCO_2, base remaining (BE) showed an upward trend before and after treatment, the difference was statistically significant. Conclusion In hypoxic-ischemic encephalopathy (Hypoxic-ischemic encephalopathy) treatment, the pathophysiological changes of the internal environment need to be dynamically observed and appropriate interventions should be provided to ensure the safe implementation of mild hypothermia.