足月和早产儿的缺氧缺血性脑病(HIE)

Prilozi Pub Date : 2022-03-01 DOI:10.2478/prilozi-2022-0013
Sandra Ristovska, O. Stomnaroska, D. Danilovski
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引用次数: 2

摘要

缺氧缺血性综合征(HIS)和缺氧缺血性脑病(HIE)是足月儿和早产儿的两种疾病,具有不同的病理生理和不同的脑部疾病。在发展中国家,HIE发生率为1-6 /1000活产,26/1000活产。15-20%在新生儿早期死亡,而幸存的婴儿有严重的神经损伤,包括脑瘫、癫痫、视力和听力障碍、认知障碍、智力、行为和社会障碍。缺氧缺血性事件发生在出生前、出生中或出生后。原因可能与母亲、分娩方式、胎盘和新生儿有关。HIE的诊断标准包括围产期因素、复苏需要、标准神经学检查、神经生理监测、神经影像学方法和生化标志物。治疗HIE最有效的方法是低温联合药物治疗。由于产科护理、新生儿复苏和体温过低不足,HIE和HIS是发展中国家仍然存在的问题。目前和新兴的HIE研究探讨了早期识别、治疗和适当的高危足月和早产儿神经保护的新标志物。
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Hypoxic Ischemic Encephalopathy (HIE) in Term and Preterm Infants
Abstract Hypoxic-ischemic syndrome (HIS) and Hypoxic-ischemic encephalopathy (HIE) are conditions that affect term and premature babies, with different pathophysiology and different brain disorders. HIE appears in 1-6 / 1000 live births and 26/1000 live births in developing countries. 15-20% die in the early neonatal period, while surviving babies have severe neurological impairment, including cerebral palsy, epilepsy, visual and hearing impairment, cognitive impairment, intellectual, behavioural, and social disorders. The hypoxic-ischemic event occurs before, during or after birth. The reasons may be related to the mother, the way of birth, the placenta, and the newborn. The criteria for diagnosis of HIE include a combination of perinatal factors, the need for resuscitation, standard neurological examinations, neurophysiological monitoring, neuroimaging methods and biochemical markers. The most effective treatment for HIE is hypothermia in combination with pharmacological therapy. HIE and HIS are problem that still persist in developing countries due to inadequate obstetric care, neonatal resuscitation, and hypothermia. Current and emerging research for HIE examines new markers for early recognition, treatment, and appropriate neuroprotection of high-risk term and premature infants.
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