重度窒息新生儿血糖监测及其影响因素分析  

BLOOD GLUCOSE MONITORING AND ITS INFLUENCING FACTORS IN NEWBORN INFANTS WITH SEVERE ASPHYXIA

作　　者：冯琪[1] 王颖[1] 

机构地区：[1]北京医科大学第一医院儿科,100034

出　　处：《新生儿科杂志》2000年第4期157-159,共3页The Journal of Neonatology

摘　　要：目的　研究重度窒息新生儿出生早期血糖的影响因素以及病程中血糖变化 ,为治疗及监护提供依据。方法 :测定 71例出生 2 4小时以内、未开奶、胎龄 37.6 9±3.40周、体重 2 788± 776 g、重度窒息新生儿的血糖 ,其中静脉输糖 32例 ,复苏用药2 2例 ,并于生后 1 0 6± 88小时内进行微量血糖监测 ,结果采用多元回归分析和卡方检验。结果 :新生儿入院年龄 3.6± 4.42小时 (中位数 2小时 ) ,入院血糖 6 .5 9±6 .43mmol/ L,高血糖 2 5例 ,低血糖 2 4例 ,合并缺氧缺血性脑病轻、中、重度各 1 3、2 1及 1 3例。入院血糖与年龄负相关 ,t=- 3.397,P=0 .0 0 1 ;与静脉输糖正相关 ,t=6 .2 30 ,P<0 .0 0 0 1 ;与复苏使用肾上腺素和 /或地塞米松正相关 ,t=2 .0 6 6 ,P=0 .0 42。血糖监测结果表明 ,随着日龄增加 ,血糖异常 (高血糖或低血糖 )发生率无明显改变 ,未发现入院血糖与缺氧缺血性脑病分度的关系。结论 :窒息复苏过程中输糖或用药 ,会对机体糖代谢产生影响 ,应慎重应用 ;To investigate the blood glucose level and its influencing factors at early age post severe neonatal asphyxia, and to provide basis for clinical monitoring and therapy. Methods Glucose level was measured in 71 severe asphyxiated newborn infants with their age less than 24 hours, no feeding, gestational age 37.69±3.40 weeks, and birth weight 2788±776g.Blood glucose were monitored 106±88 hours after birth. Results were analyzed by using multiple regression and Chi-square. Results When admitted, babies' age was 3.66±4.42 hours (median 2 hours), glucose level was 6.59±6.43 hypoglycemia in 24 babies. There were 13,21 and 13 babies suffered from hypoxic-ischemic-encephalopathy (HIE) in mild, moderate and severe degree respectively. At admitting time, glucose level related negatively with age (T=-3.397, p=0.001), and positively with glucose infusion (T=6.231,p=0.001) and drugs (Epinephrine and/or Dexamethasone) use (T=2.066 P=0.042),The in cidence of hyperglycemia and /or hypoglycemia remained same in different days during the period monitored. No relationship was found between glucose level and severity of HIE. Conclusion Glucose infusion and drugs use in neonatal asphyxia resuscitation had influence to glucose homeostasis, and should be used carefully. The monitoring and regulation should be continued in post resuscitation therapy. (Original article on page 157)

关 键 词：血糖 监测 新生儿窒息 

分 类 号：R722.1[医药卫生—儿科]