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首页> 外文期刊>Archives of disease in childhood. Fetal and neonatal edition >Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy.
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Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy.

机译：低温治疗新生儿缺氧缺血性脑病后的脑损伤。

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OBJECTIVE: The objective of our study was to examine the relationship between brain injury and outcome following neonatal hypoxic-ischaemic encephalopathy treated with hypothermia. DESIGN AND PATIENTS: Neonatal MRI scans were evaluated in the National Institute of Child Health and Human Development (NICHD) randomised controlled trial of whole-body hypothermia and each infant was categorised based upon the pattern of brain injury on the MRI findings. Brain injury patterns were assessed as a marker of death or disability at 18-22 months of age. RESULTS: Scans were obtained on 136 of 208 trial participants (65%); 73 in the hypothermia and 63 in the control group. Normal scans were noted in 38 of 73 infants (52%) in the hypothermia group and 22 of 63 infants (35%) in the control group. Infants in the hypothermia group had fewer areas of infarction (12%) compared to infants in the control group (22%). Fifty-one of the 136 infants died or had moderate or severe disability at 18 months. The brain injury pattern correlated with outcome of death or disability and with disability among survivors. Each point increase in the severity of the pattern of brain injury was independently associated with a twofold increase in the odds of death or disability. CONCLUSIONS: Fewer areas of infarction and a trend towards more normal scans were noted in brain MRI following whole-body hypothermia. Presence of the NICHD pattern of brain injury is a marker of death or moderate or severe disability at 18-22 months following hypothermia for neonatal encephalopathy.
机译：目的：本研究的目的是探讨低温治疗新生儿缺氧缺血性脑病后脑损伤与预后之间的关系。设计和患者：新生儿MRI扫描是在美国国家儿童健康与人类发展研究所（NICHD）进行的全身低温随机对照试验中评估的，并且根据MRI发现的脑损伤模式对每个婴儿进行了分类。脑损伤模式被评估为18-22个月大时死亡或残疾的标志。结果：对208名试验参与者中的136名进行了扫描（65％）。低温时73例，对照组63例。体温过低组的73例婴儿中有38例（52％）正常扫描，对照组中63例婴儿中有22例（35％）正常扫描。与对照组的婴儿（22％）相比，低温治疗组的婴儿梗塞面积较小（12％）。 136名婴儿中有51名在18个月时死亡或患有中度或严重残疾。脑损伤模式与死亡或残疾的结果以及幸存者之间的残疾相关。脑损伤模式严重程度的每一点独立地与死亡或致残几率的两倍增加相关。结论：全身低温后脑部MRI发现梗塞区域减少，扫描趋势趋于正常。新生儿脑病低体温后18-22个月时，脑损伤的NICHD模式的存在是死亡或中度或重度残疾的标志。

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