Abstract: Targeted Temperature Management（TTM）is a crucial neuroprotective strategy in pediatric neurocritical care，yet several key problems remain unresolved in its clinical application. Due to immature neurological development，high metabolic rates，and weak thermoregulation，children are more susceptible to secondary brain injury mediated by mitochondrial dysfunction，oxidative stress，and neuroinflammatory responses following acute neurological insults. TTM may exert neuroprotective effects by reducing cerebral metabolism，suppressing inflammation，and inhibiting apoptosis. However，the optimal implementation protocol（e.g.，target temperature，duration，rewarming rate）and the riskbenefit ratio in specific populations require further validation through large-scale clinical studies and long-term follow-up.

Key words: targeted temperature management, child, neuroprotection

摘要： 目标体温管理（TTM）是儿科神经重症领域的重要神经保护策略，其临床应用仍存在一些关键问题亟待解决。儿童由于神经系统发育不成熟、代谢率高及体温调节能力弱等特点，更易在急性神经损伤后出现线粒体功能障碍、氧化应激损伤及神经炎性反应等介导的继发性脑损伤。TTM通过降低脑代谢、抑制炎症和减少细胞凋亡等机制发挥可能的神经保护作用。然而，特定人群的获益风险比及其最佳实施方案（如目标温度、持续时间及复温速率）仍需通过大样本临床研究和长期随访进一步验证。

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