围产期窒息对新生儿肾功能影响及判断指标评价

AFFECT OF PERINATAL ASPHYXIA ON NEONATAL RENAL FUNCTION AND ITS VALUATION OF JUDGING INDEXES

围产期窒息是新生儿肾功能不全的重要病因。本文分析73例因产期窒息地的肾功能改变。结果示围产期窒息致急性肾功能衰竭的发生率为31．5％，病死率21．7％。肌辞清除率是肾功能不全的可靠敏感指标。尿β2－微球蛋白对新生儿肾功能损害的诊断意义不大。用随意尿测定的钠排出分数及肾衰指数对肾功判断有其可信性。与低血钠不相伴随的持续性低氯血症可能提示有近曲以远肾小管功能损害。临床缺氧程度与肾功损害严重度相关，提示应及时有效复苏以减少肾损害。

SUMMARY Perinatal asphyxia is one of the major carst to neonatal renal dysfunction.This study analysed the alterations of renal functions in 73 cases of newborns with perinatal asphyxia. The results showed that the frequency of neonatal acute renal failue was 31. 5%,the mortality was 21. 5％ in this growp of perinatal asphyxia. The creatinine crearence was the most credible and sensitive index for renal dysfunction. 5,-microglobuline of urine had little diagnostic signification in early newborn. The fractional natrium excretion and renal failue index from random urine specimen had a referential value in judgement of renal function. Persistent hypochloremia disassociated from hyponatrinemia could be a clue suggesting segmental dysfunction of post-proximal renal tubules. The degree of renal damages related to the clinical severity of hyposia, which suggested that resucitation should be in time and effectively as to diminish the renal damage.