关于新生儿缺血缺氧性脑病的研究进展

新生儿缺血缺氧性脑病(hypoxia-ischemia encephalopathy,HIE)是指围产期窒息导致脑的缺血缺氧性损害,临床出现一系列中枢神经系统异常的表现,部分患儿可留有不同程度的神经系统后遗症,如脑瘫、癫痫、认知和运动功能发育障碍等,至今仍是导致新生儿死亡以及神经发育障碍的一大原因。HIE的发病机制复杂,是一个多环节、多因素的病理生理过程。单一治疗措施很难彻底治愈,需多种治疗措施联合使用,才能取得更好疗效。HIE发病迅速,病情进展快,治疗过程中应积极把握治疗"时间窗"。临床上目前应用最广泛的治疗方法是亚低温结合其他对症治疗措施。新生儿HIE难以有效预防,及时正确评估新生儿出生时状态,尽早发现异常并进行治疗是改善HIE预后最有效的方法。本文就HIE的病因,诊断,治疗和预后等方面的进展进行介绍。

The Research Progress of Neonatal Hypoxic-ischemic Encephalopathy

ABSTRACT: Neonatal hypoxic-ischemic encephalopathy (HIE) is an important cause of acute neurologic injury at birth, mainly due to perinatal asphyxia. There are a series of abnormal manifestations of central nerve system, and part of infants with HIE would remain long-term devastating neurodevelopmental sequelae, like cerebral palsy, seizures, cognitive and motor dysfunction. Despite recent ad- vances in obstetric and neonatal care, HIE still associated with death and neurodevelopmental disorders of newborns worldwidely. The pathogenesis of HIE is complex, involving multi-link and multi-factor. Therapeutic hypothermia(TH) is now widely recommended as a standard of care for infants with HIE.The timing of TH is critical, mostly induced within 6 h of an acute asphyxia insult. It''s hard to pre- vent HIE. Assessing the state of infants at birth correctly and treating the problems timely are significant. This review is a introduction of pathogenesis, diagnosis, treatment progress and prognosis of HIE.