中国体外生命支持2025，Vol.23Issue(5)：394-398,5.DOI:10.13498/j.cnki.chin.j.ecls.2025.05.04
亚低温治疗对先天性心脏病体外膜氧合术后神经行为发育的影响
A Randomized Controlled Study:the Effects of Mild Therapeutic Hypothermia on Neurobehavioral Development After Extracorporeal Membrane Oxygenation
摘要
Abstract
Objective To investigate the protective effect of mild hypothermia on postoperative neurobehavioral devel-opment in CHD patients with ECMO.Methods This was a randomized controlled study.Since Oct.2018,patients who met the inclusion criteria after cardiac surgery were randomly divided into mild hypothermia ECMO group or normal temperature ECMO group by envelope method.Mild hypothermia was achieved by using a water tank,and the core temperature was controlled at 34℃±0.5℃for 48-72 hours.The other treatment plans were the same.The children were followed up regularly for brain MRI and Griffiths neurobehavioral development assessment.Results From Oct.2018 to Jun.2020,a total of 33 cases were enrolled.The overall survival rate was 69.70%(23/33 cases),with no significant difference between the two groups.The minimum tem-perature of the mild hypothermia was 34.28℃±0.53℃,the mean duration was 58.00 hrs±15.56 hrs,and no obvious compli-cations related to mild hypothermia treatment were identified.By Oct.2021,the follow-up rate of the mild hypothermia group was 83.33%(10/12 cases)and that of the normal temperature group was 63.64%(7/11 cases).The brain MRI score of the two groups was 1.33±1.06 and 1.21±1.15,respectively,with no significant difference between the two groups(P=0.833).In terms of Griffiths assessment results,the DQ of patients in the mild hypothermia group was higher than that of patients in the normal temperature group in B person-society,C language,D hand-eye coordination,and E performance,and there were statistically significant differences in C and E(P=0.049 and P=0.012).Conclusion ECMO combined with mild hypothermia did not sig-nificantly increase the complications of blood system and circulation system in CHD patients after surgery.The early postopera-tive neurobehavioral development results of children in the mild hypothermia group were better than those in the normothermia group,especially in the fields of language and performance.关键词
先天性心脏病/儿童/心脏术后/体外膜氧合/亚低温/机械辅助/神经行为发育/随访Key words
congenital heart disease/children/postcardiotomy/extracorporeal membrane oxygenation/mild hypothmia/mechanical assistance/neurobehavioral development/follow-up引用本文复制引用
沈佳,杨寅愉,张蔚,于新迪,郭铮,姜磊,黄坚鹄,王伟..亚低温治疗对先天性心脏病体外膜氧合术后神经行为发育的影响[J].中国体外生命支持,2025,23(5):394-398,5.基金项目
国家自然科学基金(82470417) （82470417）
中央高校基本科研业务费专项资金资助(YG2024QNB24) （YG2024QNB24）
