窒息新生儿生后72小时内电解质变化的临床研究

Clinical research on changes of electrolytes within 72 h ours in asphyxia neonates

目的研究窒息新生儿生后72h内三个不同时间段电解质水平变化及电解质紊乱情况。方法选择符合观察条件的重度窒息新生儿23例（重度窒息组），轻度窒息新生儿27例（轻度窜息组），分别于生后0～24h、25～48h、49～72h三个时间段抽取静脉血2ml检查，对比两组不同时间段血钠、钾、氯、钙、磷、镁等电解质水平变化情况及低钠、钾、钙、镁血症发生率。结果生后三个时间段血钠、钙水平重度窒息组明显低于轻度窒息组（P〈0．05）；血镁水平在25～48h和49～72h时间段重度窒息组明显低于轻度窒息组（P〈0．05），而在0～24h时间段差异无统计学意义（P〉0．05）；血钾水平仅在49～72h时间段重度窒息组明显低于轻度窒息组（P〈0．05）；血氯、磷水平在各个时间段两组比较差异均无统计学意义（P〉0．05）。结论窒息新生儿生后易发生电解质紊乱，以25～48h时间段为甚，而低镁血症则多发生在25—48h、49—72h两个时间段。应在不同时间段检测血气、电解质水平变化并采取相应措施予以纠正电解质紊乱。

Objective To analyse the changes of electrolytes and electrolyte disturbances within 72 h in asphyxia neonates. Methods Twenty-three severe-asphyxia neonates （asphyxia group） and 27 mild- asphyxia neonates （control group） were selected.Venous blood samples of 2 ml were drawn at 0-24 h, 25-48 h and 49-72 h respectively. The changes of electrolytes （such as plasma sodium, potassium, chlorine, calcium and magnesium） and the incidence of hyponatremia, hypokatemia, hypoealcaemia and hypomagnesemia were compared between two groups. Results The levels of plasma sodium, calcium at 0-24 h, 25-48 h and 49-72 h in asphyxia group were lower than those in control group （P 〈 0.05）. The levels of plasma magnesium at 25-48 h and 49-72 h in asphyxia group were lower than those in control group （ P 〈 0.05 ）, but there was no significant difference at 0-24 h （ P 〉 0.05 ）. The levels of plasma potassium at 49-72 h in asphyxia group was lower than that in control group（P 〈 0.05 ）. There were no obvious changes in plasma chlorine, phosphorus in two groups （P 〉 0.05）. Hyponatremia, hypokalemia, hypocalcaemia was happened within 72 h in asphyxia neonates especially at 25-48 h, but hypomagnesemia was more at 25-48 h and 49-72 h. Conclusion Electrolyte disturbances can appear not only in 24 h, but also in different periods after asphyxia, therefore, it is necessary to maintain homeostasis by taking eorresponding measures according to the changes of blood gas and the changes of electrolytes.