治疗标准:
标准 A:超过 34 周的新生儿完成 GA 时至少有 1 个严重酸中毒参数:
- 5 分钟时阿普加小于 5。
- 在产房进行复苏10分钟以上,使用正压通气(面罩或气管插管)。
- 出生后第一小时最差的气体测定(脐带血、动脉血、静脉血或毛细血管血)的 pH 值小于 7。
- 出生后第一小时最差血气分析(脐带血、动脉血、静脉血或毛细血管血)中碱不足大于 16 mmol/L。
标准 B。所有符合标准 A 的新生儿都将使用标准 B 进行神经学评估。
- 癫痫发作。
- 中度或重度 HIE 症状:必须满足以下 3 个标准:
- 意识状态改变(对刺激的反应减弱或消失)。
- 音调异常(局部或全身肌张力减退)。
- 原始反射异常(吸吮弱/缺失、Moro 异常等)。
标准 C:脑电图描记。将尽快使用 aEEG 监测活动至少 30 分钟。
可能会出现两种情况:
- 正常aEEG(CNV):在生命的最初6小时内,它表明神经学预后正常的可能性很高,如果神经学检查一致(轻度HIE),将考虑撤回低温。只要有可能,就应将其与传统脑电图进行对比。
- aEEG 改变:证实中重度 HIE 的诊断,治疗应持续 72 小时:
- 正常基线追踪 (CNV) 与癫痫发作。
- 癫痫持续状态。
- 改变的碱基追踪:DNV,疫情抑制。
- 抑制碱基迹线:低电压,等电。

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