围生期窒息新生儿血液生化指标检测价值探讨  

Approach on detection value of blood biochemical indicators in newborn asphyxia during perinatal period

作　　者：韩明亮[1] 李洪丽[1] 张宝林[1] 李宁[1] 苏云霄[1] 胡令英[1] 

机构地区：[1]山东省滨州市中心医院,山东惠民251700

出　　处：《现代中西医结合杂志》2011年第5期525-527,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨新生儿窒息后血液生化指标的变化及临床意义。方法选择52例窒息新生儿,分为重度窒息组、轻度窒息组,均于生后48 h内采股静脉血分别测定血清谷草转氨酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB、CK-BB)、K+、Na+、Cl-、BUN、Cr、CO2-CP、Ca2+的变化。结果新生儿窒息后AST、CK、CK-MB、CK-BB、BUN、Cr明显升高,CO2-CP、Na+、Cl-、Ca2+水平显著下降,且与窒息程度成正比,窒息越重,变化越明显。血清K+仅在重度窒息组有明显变化;宫内窘迫窒息组AST、CK、CK-MB、CK-BB、BUN、Cr水平升高,CO2-CP、Na+、Cl-、Ca2+水平降低,与出生时及出生后窒息组比较均有显著性差异;重度窒息组缺氧缺血性脑病、吸入性肺炎及呼吸暂停发生率明显高于轻度窒息组,其他并发症发生率无显著性差异;新生儿窒息后经过综合治疗措施的早期干预,各类指标均有明显恢复,接近正常水平。结论新生儿窒息缺氧后,AST、CK、CK-MB、CK-BB、K+、Na+、Cl-、BUN、Cr、CO2-CP、Ca2+发生明显变化,可作为早期检测指标,反映窒息后各脏器功能受损情况。Objective It is to approach the changes and clinical significance of blood biochemical indicators after newborns asphyxia.Methods 52 asphyxial newborns were chosen and divided into severe asphyxia group and mild asphyxia group.The changes of AST,CK,CK-MB,CK-BB,K＋,Na＋,Cl-,BUN,Cr,CO2-CP and Ca2＋ in their serum were detected within 48 h after birth.Results The levels of AST,CK,CK-MB,CK-BB,BUN and Cr obviously heightened after asphyxia while the levels of CO2-CP,Na＋,Cl-and Ca2＋ significantly lowered.The changes had direct proportion with asphyxia degree.The worse asphyxia was,the more obvious the changes were.The level of serum K＋ showed obvious change only in severe asphyxia group.The levels of AST,CK,CK-MB,CK-BB,BUN and Cr heightened in fetal distress asphyxia group while the levels of CO2-CP,Na＋,Cl-and Ca2＋ lowered,which were significant differences compared with asphyxia at birth and after birth group.The incidence rates of hypoxic ischemic encephalopathy,aspiration pneumonitis and apnea in severe asphyxia group were obviously higher than that in mild asphyxia group.There were no significant differences on the incidence rates of other complication.After newborn asphyxia,all indexes were resumed to nearly normal levels after given early intervention of comprehensive measures.Conclusion After newborn asphyxia,AST,CK,CK-MB,CK-BB,K＋,Na＋,Cl-,BUN,Cr,CO2-CP and Ca2＋ may change obviously,which can be used as early detective indicators to show the dysfunction of organs after asphyxia.

关 键 词：围生期 窒息新生儿 生化指标 

分 类 号：R722.12[医药卫生—儿科]