54例新生儿脑水肿血清渗透压临床监测研究  

Monitoring serum osmolality in 54 newborn infants with brain edema

作　　者：祁伯祥[1] 杨于嘉[1] 林小娟[2] 谢岷[1] 王霞[1] 

机构地区：[1]中南大学湘雅医院新生儿科 [2]湖南省人民医院儿科

出　　处：《中国新生儿科杂志》2006年第1期15-17,共3页Chinese Journal of Neonatology

摘　　要：目的探讨脑水肿新生儿血清渗透压的变化规律及其在临床治疗中的指导作用。方法用微量渗透压仪(美国,Model 3300)分别在入院当时、入院后第3、7天测定54例脑水肿新生儿及其电解质。以11例正常新生儿血清渗透压作为正常参考值。结果与正常新生儿血清渗透压相比,新生儿缺氧缺血性脑病(HIE)患儿第1、3天显著降低,第7天恢复正常；窒息新生儿第1、3天明显下降,第7天恢复正常：颅内出血新生儿的血清渗透压第1天显著增高,第3天明显增高,第7天恢复正常；呼吸窘迫伴重症肺炎新生儿渗透压第1、3天显著降低,第7天仍低于正常。结论不同病因引起新生儿脑水肿的血清渗透压下降程度及持续时间有所不同,窒息、HIE和呼吸窘迫伴重症肺炎患儿早期渗透压多有不同程度下降,同时存在低钠血症,颅内出血新生儿血清渗透压早期可增高。血清渗透压测定可有效帮助临床医师判断脑水肿新生儿病情变化及指导治疗。Objective To explore the serum osmolality changes and their significant fortreatment in the newborn with brain edema. Methods Using the micro-osmomter （the AdvancedTM MICRO-OSMOMETER, Model 3300） to assay serum osmolality, and electrolyte in 54 neonates with brain edema on the 1 st,3 rd and 7 th day. Eleven normal neonataes were chosen to be as controlResults The serum os- molality of hypoxic-ischemic encephalopathy （HIE） neonate and asphyxiated neonae was lower than normal value remarkably on the 1 st and 3 rd day, and resumed on the 7 th day. The serum osmolality of neonate with intracranial hemorrhage （ICH） was higher than normal value on the 1 st and 3 rd day, and it was normal on the 7 th day. The serum osmolality of neonates with respiratory distress and/or sever pneumonia were lower than normal value significantly on the 1 st and 3 rd day, and kept lower persistently on the 7th day. The ICH of newborn presented hypernatremia and the other diseases presented hyponatremia in the early days while on the 7 th day all were resumed. Conclusions The serum osmolality in neonates with brain edema is changed with pathogenesis and age. Mornitoring the serum osmolality may be helpful for the assessment of the severity and the clinical treatment of neonatal brain edema.

关 键 词：脑水肿 新生儿 血清渗透压 电解质 

分 类 号：R722.1[医药卫生—儿科]