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、72 h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72 h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 investigate the internal environment changes of whole-body hypothermia on neonatal hypoxic-ischemia encephalopathy. Methods Twenty-nine hypoxic-ischemia encephalopathy neonates were randomized to either systemic hypothermia group(n=15) or normothermia group(n=14).The infants in hypothermia group were got parental consent and maintained rectal temperature 33.0℃~34.0℃ for 72 h by cooling.The other supportive treatments were the same in both groups.The dynamic changes of serum Ca²⁺,Na⁺,Cl^-,K⁺,PH,BE,ALT,AST,BUN,Cr,CK-MB at 0 and 72 hours after admission were monitored respectively. Results At the time of 72 h after admission,levels of serum Ca²⁺ and Na⁺ in systemic hypothermia group were higher than those in normothermia group;the level of serum CK-MB in systemic hypothermia group were lower than those in normothermia group;and levels of serum Cl^-,K⁺,ALT,AST,BUN,Cr,BE and PH were no differences between this two groups. Conclusion Systemic hypothermia on neonatal hypoxic-ischemia encephalopathy can improve hypocalcemia and hyponatremia,without aggravated damagements of liver,kidney and acid-base balance,even may have neuroprotective effects on damaged myocardium.