新生儿窒息后血糖及电解质改变的临床意义

THE CLINICAL SIGNIFICANCE OF THE CHANGES OF BLOOD SUGAR AND SERUM ELECTROLYTES IN ASPHYXIA OF NEWBORN

目的研究窒息新生儿出生早期血糖、电解质的变化,为治疗及监护提供依据。方法窒息新生儿在生后24h内采取股静脉或颈静脉血2ml。观察组采血时平均日龄8.62h,对照组10.2h,留取血糖标本均在喂养和输液前取血。结果观察组血糖明显低于对照组,其中血糖<2.24mmol/L者,观察组11例(34.4%),对照组2例(6.7%),两组比较差异显著(2=4.79,p<0.05)。观察组血清肌酐明显高于对照组,差异非常显著。其中血清肌酐≥132μmol/L者6例。血清钠浓度低于对照组,其中血清钾>6.4mmol者观察组18例,对照组6例,两组差异显著(2=3.89,p<0.05)。血清钠<124mmol/L者观察组23例,对照组9例,差异非常显著(2=10,p<0.01)。两组血清氯比较无明显差异。观察组血钙低于对照组,其中低于1.8mmol/L者观察组8例,对照组1例,差异显著(2=4.44,p<0.05)。结论新生儿窒息复苏后注意血糖、血钠、钙、钾的检测,防止低血糖、高血糖及电解质紊乱等并发症的发生。对降低新生儿窒息的死亡率,减少后遗症的发生均有重要意义。

Objective To provide clinical data in evaluating and supervising the asphyxia of newborn by detecting the changes of the serum electrolytes and blood sugar. Methods 2 ml blood samples were taken via jugular or femoral venous puncture and samples for blood sugar taken before feeding or transfusion, from whom the newborns with asphyxia were 8.6 hours post partum in test group and 10, 2 hours in control group. Results Comparing with control group, the average level of blood sugar, the serum creatinine and serum potassium in test group was significantly high; while the level of serum sodium and serum calcium in test group was significantly low, and there was no significant difference on the serum chlorine between the two groups. Conclusion After resuscitation from asphyxia, the newborns are incident to many complications, The intensive supervision on the serum electrolytes and blood sugar should be beneficial to prevent the incidence of complication and reduce the mortality.