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臨床婦人科産科67巻9号

2013年09月発行

文献概要

今月の臨床 脳性麻痺─発症防止への挑戦 脳性麻痺発症率低減への戦略

10.脳低温療法の実際

著者: 茨聡1

所属機関: 1鹿児島市立病院総合周産期母子医療センター新生児科

ページ範囲:P.951 - P.959

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●脳低温療法には,表面冷却法と血管内冷却法がある.

●脳低温療法の適応基準は,臍帯血pH<7.00,アプガースコア5点以下(10分値),10分以上の新生児蘇生,中等症─重症の脳症,脳波異常,両親の承諾,が重要である.

●脳低温療法により,約40%の低酸素性虚血性脳症の予後を改善できる.

参考文献

1) 林 成之 : 脳低温療法.総合医学社,1995
2) 片岡喜由,林 成之 : 脳低温療法の基礎と臨床.総合医学社,1998
3) Kobayashi K, Ibara S, Kusumoto M, et al : Changes of lactate,glucose,ionized calcium and glutamate concentrations in cephalic vein blood during brain hypothermia using extracorporeal membrane oxygenation(ECMO) in a newborn infant with hypoxic-ischemic encephalopathy. J Pernat Med 33 : 360─363, 2005
4) Gluckman PD, Wyatt J, Azzopardi D, et al : Selective head cooling with mild systemic hypothermia after neonatal encephalopathy : multicentre randomized trial. Lancet 365 : 663─670, 2005
5) Shankaran S, Laptook A, Ehrenkranz RA, et al : Whole-Body Hypoyhermia for Neonates with Hypoxic-Ischemic Encephalopathy. N Engl J Med 353 : 1574─1584, 2005
6) Azzopardi DV, Strohm B, Edwards AD, et al : Moderate Hypothermia to Treat Perinatal Asphyxial Encephalopathy. N Engl J Med 361 : 1349─1358, 2009
7) EdwaedsAD, Brocklehurst P, Gunn A, et al : Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy : synthesis and meta-analysis of trial data. BMJ 340 : c363, 2010. doi : 10, 1136/bmj.c363
8) Saranat HB, Sarnat MS.Neonatal encephalopathy following fetal distress. Aclinical and electroencephalographic study. Arch Neurol 33 : 696─705, 1976
9) Fetal and Neonatal Neurologic Injury : ACOG Technical Bulletin NUMBER 163─JANUARY 1992
10) Goldaber KG, Gilstrap LC 3rd, Levono KJ, et al : Payhologic fetal academia. Obstet Gynecol 78 : 1103─1107, 1991
11) Winkler CL, Hauth JC, Tucker JM, et al : Neonatal Complication at term as related to the degree of umbilical artery academia. Am J Obstet Gynecol 164 : 637─641, 1991
12) Gilstrap LC 3rd, Levono KJ, Burris J, et al : Diagnosis of birth asphyxia on the basis of fetal pH, Apgar score, and newborn cerebral dysfunction. Am J Obstet Gynecol 161 : 825─830, 1989
13) Sehdev HM, Stamilio DM, Macones GA, et al : Predictive factors for neonatal morbidity in neonates with an umbilical arterial cord pH less than 7.00. Am J Obstet Gynecol 177 : 1030─1034, 1997
14) Andres, Saade G, Gilstrap LC, et al : Association between umbilical blood gas parameters and neonatal morbidity and death in neonates with pathologic fetal acidemia. Am J Obstet Gynecol 181 : 867─871, 1999
15) Goodwin TM, Belai I, Hernandez P, et al : Asphyxial complications in the term newborn with severe umbilical acidemia. Am J Obste Gynecol 167 : 1506─1512, 1992
16) Ruth VJ, Raivio KO, Perinatal brain damage : predictive value of metabolic acidosis and the Apgar score. BMJ 297 : 24─27, 1988
17) Nelson KB, Ellenberg JH : Apgar scores as predictors of chronic neurologic disability. Pediatrics 68 : 36─44, 1981
18) Perlman JM, Tack ED, Martin T, et al : Acute systemic organ injury in term infants after asphyxia. Am J Dis Child 143 : 617─620, 1989
19) Martin-Ancel A, Garcia-Alix A, Gaya F, et al : Multiple organ involvement in perinatal asphyxia. J Pediatr 127 : 786─793, 1995
20) Coimbra C, Wieloch T : Moderate hypothermia mitigates neuronal damage in the rat brain when initiated several hours following transient cerebral ischemia. Acta Neuropathol(Berl) 87 : 325─331, 1994

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1294

印刷版ISSN:0386-9865

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