择期剖宫产足月儿低血糖发生率分析  

Incidence of hypoglycemia in full-term neonates delivered by selective cesarean section

作　　者：刘晓红 杜娟 梁云梅[1] 纪丽丽 王雅军 钱宁 曹凤翔 张玲 LIU Xiao hong;DU Juan;LIANG Yun-mei;JI Li-li;WANG Ya-jun;QIAN Ning;CAO Feng-xiang;ZHANG Ling(Jingxi Campus,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院京西院区,北京100043

出　　处：《中国妇幼健康研究》2018年第8期1049-1052,共4页Chinese Journal of Woman and Child Health Research

基　　金：北京市石景山区卫计委医学重点扶持专科建设资助项目(编号:20170001)

摘　　要：目的探讨择期剖宫产对足月新生儿早期低血糖发生率影响,比较口服配方奶和口服葡萄糖纠正低血糖的疗效。方法选择2017年1月至4月首都医科大学附属北京朝阳医院京西院区63例因瘢痕子宫或臀位择期剖宫产足月新生儿及56例顺产足月新生儿为研究对象,对所有入组新生儿于生后30分钟内行末梢血血糖值检测。同时对27例末梢血血糖值低于2.6mmol/L新生儿中的22例进行口服配方奶干预,5例口服葡萄糖干预。结果健康组、妊娠合并甲减组和妊娠合并糖尿病组剖宫产的新生儿低血糖发生率均显著高于顺产的新生儿(均P<0.05)。健康组、妊娠合并甲减组和妊娠合并糖尿病组不同孕周剖宫产新生儿低血糖发生率比较均无显著性差异(均P>0.05)。40例低血糖新生儿中,13例住院接受治疗,剩下的27例末梢血血糖值低于2.6mmol/L足月新生儿中,22例接受了口服配方奶干预,5例接受了口服10%葡萄糖干预,两组间新生儿低血糖纠正效果比较无显著性差异(χ~2=0.29,P>0.05)。结论择期剖宫产是足月新生儿发生早期低血糖的影响因素,孕周对剖宫产足月新生儿早期低血糖的发生率无影响,口服配方奶或葡萄糖纠正足月新生儿早期低血糖疗效相似。Obsjective To explore the effect of selective cesarean section on the incidence of early hypoglycemia in full-term neonates and compare the efficacy of oral formula and oral glucose in correcting hypoglycemia.Methods From January to April 2017,63 fullterm neonates from Jingxi Campus of Beijing Chaoyang Hospital of Capital Medical University delivered by selective cesarean section as a result of scarred uterus or breech position and 56 full-term neonates born naturally were included in clinical observation.The peripheral blood glucose levels of all neonates were measured 30 minutes after birth.Of 27 cases whose peripheral blood glucose value was lower than 2.6 mmol/L,22 were treated with oral formula and 5 received oral glucose intervention.Results The incidence of hypoglycemia in neonates delivered by cesarean section in healthy group,gestational hypothyroidism group and gestational diabetes group was significantly higher than that in natural birth group（all P〈0.05）.There was no significant difference in the incidence of hypoglycemia among the cases with different gestational weeks in healthy group,gestational hypothyroidism group and gestational diabetes group（all P〈0.05）.Of the 40 cases of hypoglycemia,13 were hospitalized in hospital,22 of 27 cases whose peripheral blood glucose value was lower than 2.6 mmol/L were treated with oral formula and 5 received 10% oral glucose intervention,and there was no significant difference between two groups of neonates in hypoglycemia correction（χ~2=0.29,P〈0.05）.Conclusion Selective cesarean section is an influencing factor of early hypoglycemia in full-term neonates,and gestational age has no effect on the incidence of early hypoglycemia in those delivered by cesarean section.Oral formula has similar effect with glucose in correcting early hypoglycemia in full-term neonates.

关 键 词：剖宫产 择期 足月新生儿 低血糖 

分 类 号：R725.8[医药卫生—儿科]