アブストラクト
| Title | 2. 低体温療法 |
|---|---|
| Subtitle | 特集 新生児低酸素性虚血性脳症の最前線 - 近未来の管理 / 治療戦略 |
| Authors | 岩田欧介, 津田兼之介, 川瀬恒哉, 岩田幸子 |
| Authors (kana) | |
| Organization | 名古屋市立大学大学院 医学研究科 新生児・小児医学分野 |
| Journal | 日本新生児成育医学会雑誌 |
| Volume | 33 |
| Number | 1 |
| Page | 31-35 |
| Year/Month | 2021 / 2 |
| Article | 報告 |
| Publisher | 日本新生児成育医学会 |
| Abstract | 「要旨」低体温療法は神経科学が人類にもたらした最初の脳保護療法である. しかし, 新生児に先駆けて冷却の有効性を確立した成人の蘇生後脳症では, 近年, 体温を36℃に精密調整する平易な管理targeted temperature managementに主役を譲り, その明確な役割を失いつつある. 新生児の中等症以上の脳症に対する冷却は, そのエビデンスによる支持をますます盤石なものにしつつあるが, 冷却法の改良・適応拡大・併用療法の開発に関しては, この10年間に目立った進歩はない. 近年, このような停滞ムードを吹き飛ばす大きな動きが, 世界レベルで活発化している. 標的となる病態は, 現行の冷却基準をわずかに満たさない"軽症脳症"と言われる一群である. 本稿では, 低体温療法応用の道のりを簡単に振り返り, 近年の重要な成果と失敗を共有した後に, なぜ軽症脳症が新しい適応病態として最右翼に位置するのか, なぜその発症頻度・予後・低体温療法の効果が最優先で検討されるべきなのかを概説したい. |
| Practice | 臨床医学：内科系 |
| Keywords | 新生児, 低酸素性虚血性脳症, 重症度, 低体温療法, 予後操作因子 |
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