新生儿低血糖的危险因素及预防

Risk factors and prevention of neonatal hypoglycemia

目的分析非糖尿病母亲分娩的新生儿发生低血糖的危险因素及预后，为临床诊治提供依据，避免发生脑损伤。方法采用病例对照的方法，选取诊断明确的非糖尿病母亲分娩的低血糖新生儿111例为病例组，以同期血糖正常的新生儿111例为对照组，分析新生儿低血糖的危险因素及低血糖后神经发育情况。结果新生儿低血糖的危险因素为低出生体重儿（r=4．066，P=0．044）、小于胎龄儿（r=21．125，P=0．000）、先天性心脏病（r=5．869，P=0．015）、日龄≤3d（r=6．876，P=0．032）、母亲患有妊娠期高血压疾病（r=6．618，P=0.010）或年龄〈25岁（χ^2=6．311，P=0．044）。足月儿比早产儿可能更易出现低血糖性脑损伤；低血糖性脑损伤的发生与血糖水平及低血糖持续时间相关。结论对存在引起低血糖高危因素的新生儿要严密监测血糖，及时发现及时治疗，避免低血糖引起脑损伤。

Objective To analyze the risk factors and prevention of non-diabetic mother neonatal hypoglycemia, in order to provide evidences for clinical diagnosis and avoid hypoglycemic brain injuries. Methods This was retrospective study using the method of case control. One hundred and eleven cases of non-diabetic mother neonatal hypoglycemia were enrolled in patients group, and 111 controls of normal blood glucose neonate at the same period were enrolled in control group. The risk factors of neonatal hypoglycemia and the results of neural development after hypoglycemia were analyzed. Results The risk factors of neonatal hypoglycemia were low-birth-weight infant （χ^2 = 4.066, P = 0.044）, small for gestation age infant （ χ^2 = 21.125, P = 0.000）, congenital heart disease（ χ^2 = 5.869,P = 0.015）, day-age ≤ 3 days（ χ^2 = 6.876, P = 0.032）, mother with pregnancy-induced hypertension （ χ^2 = 6.618, P = 0.010） or age 〈 25 years old （χ^2 = 6.311 ,P = 0.044）. Full-term infants might be easier to show up hypoglycemic brain injuries than pre-term infants; the occurrence of hypoglycemic brain injuries correlated with the level of blood glucose and the lasting time of hypoglycemia. Conclusion Monitor blood glucose closely to the infant has risk factors of hypoglycemia, and discover and cure it on time, in order to avoid hypoglycemic brain injuries.