出生1～7d早产儿12h自由排尿观察

Free Voiding Observation for 12 Hours in Preterm Newborns under 7 Days Old

目的探讨出生7d内早产儿的自由排尿特点。方法选取2010年3-5月在本院NICU住院的113例出生7d内无疾病的单胎早产儿。男60例,女53例;胎龄32～36周[(34.0±1.9)周];体质量1.16～2.07kg[(1.48±0.34)kg]。据日龄分为7组(第1天组～第7天组)。第1天组6例,第2天组11例,第3天组11例,第4天组18例,第5天组18例,第6天组26例,第7天组23例。每组均进行12h(9:00-21:00)自由排尿观察,记录排尿时间、每次排尿量,B超测量排尿后残余尿量,排尿时觉醒状态。结果 113例早产儿12h共观察排尿745次。第1天组6例早产儿观察时段位于出生0.5～12.5h,12h内排尿1～4次[(2.8±1.2)次],其中5例出生4h内无排尿。第3天组开始发现早产儿排尿前有手臂或大腿微动或排尿后啼哭现象。第2、3、4天组平均2.5h排尿1次。第5、6、7天组平均不到2h排尿1次。第1天组、第4天组、第7天组排尿次数、排尿量比较差异均有统计学意义(Pa<0.05)。各组残余尿量比较差异均无统计学意义(Pa>0.05),膀胱排空率均低于30%。总体27.39%(204/745次)的排尿发生在清醒状态。间断排尿(10min内排尿次数≥2)见于第2天组以后的早产儿,达70%(522/745次)。结论出生7d内的早产儿中枢神经系统参与排尿不明显。每次排尿量及排尿次数变异较大,但有随日龄增加的趋势。

Objective To investigate 12-hour free voiding characteristics of preterm newborns under 7 days old.Methods A total of 113 single-birth preterm newborns,60 male and 53 female,without pathological diseases,single birth,gestational age between 32-36 weeks[（34.0±1.9）weeks],birth weight 1.16-2.07 kg[（1.48±0.34）kg],aged 1 to 7 days,hospitalized in NICU at the First Affiliated Hospital of Zhengzhou University from Mar.to May 2010,were included in this study.They were divided into 7 groups according to their birth time.First group had 6 premature newborns,the second group had 11 cases,third group had 11 cases,fourth group had 10 cases,fifth group had 18 cases,sixth group had 26 cases,and seventh group had 23 cases.Each group undertook 12-hour（900-2100）free voiding observation,and voiding time,voiding volume,post-voiding residual urine（PVR）were recorded by B ultrasound,awake or sleep when voiding was recorded.Results One hundred and thirteen preterm newborns voided 745 times,in which 1-day-group were 0.5-12.5 hours old and voided 1-4 times[（2.8±1.2）times];5 cases didn＇t void in 4 hours.Some newborns over 3 d had arm or thigh fretting before voiding or crying after voiding.Group-2 d,group-3 d and group-4 d voided once per 2.5 h.Group-5 d to 7 d voided once per 2 h.There were significant differences between groups 1,4,7 d in voiding frequency and voiding volume（P0.05）and great variation in voiding volume for all groups.The PVR showed no statistical difference（P0.05）between different groups and bladder emptying rate were all below 30%.About 27.39%（204/745 times）voiding occurred while awake.Intermittent voiding pattern（urination ≥2 every 10 min）was found in newborns over 2 days,up to 70%（522/745 times）.Conclusions Bladder voiding function of premature newborns has not yet fully developed,but improves quickly after birth.Central ner-vous system may get involved in some subtle of urination.