窒息新生儿早期微量血糖动态监测的临床价值

Clinical value of early trace blood glucose monitoring in neonates with asphyxia

目的探讨对窒息新生儿早期监测微量血糖的I临床意义。方法采用微量血糖仪对56例足月窒息新生儿和50例足月正常新生儿在出生24小时内的7个时段（1、2、4、6、8、12、24小时）进行微量血糖监测，并进行比较分析。结果重度窒息足月新生儿微量血糖平均值随小时龄增加呈不断递减现象，而轻度窒息者和正常足月新生儿则随小时龄增加呈不断递增现象，3组均以生后6小时内血糖平均值递减递增现象表现突出。在生后6小时内重度窒息组在每个小时龄段发生高血糖的比率较轻度窒息组的高（Х^2值分别为19．22、17．25、7．97、5．38，均P〈0．05）；相反轻度窒息组在每个小时龄段发生低血糖的比率则较重度窒息组的高（Х^2值分别为18．21、12．58、6．29、5．18，均P〈0．05），而且窒息程度越重，血糖异常数及异常率越高。随着小时龄的增加和治疗的作用，3组新生儿血糖异常数及异常率均出现递减现象。结论新生儿窒息可出现糖代谢紊乱，因此加强窒息新生儿早期血糖监测对判断病情、指导治疗及改善预后均有重要临床价值。

Objective To discuss the clinical significance of early trace blood glucose monitoring in neonates with asphyxia. Methods Trace blood glucose meter was used to monitor the trace blood glucose of 56 cases of full-term neonates with asphyxia and 50 cases of full-term normal newborns at 7 time points （ 1, 2, 4, 6, 8, 12, 24 hour） within 24 hours after delivery, and the results were compared and analyzed. Results Average trace blood glucose of full-term neonates with severe asphyxia was constantly decreasing with increasing of hours of age, while that of full-term neonates with mild asphyxia and normal full-tern1 newborns increased. The average trace blood glucose decreased or increased significantly with 6 hours in these three groups. The incidence rate of hyperglycemia in severe asphyxia group at different hours of age with 6 hours was higher than that in mild asphyxia group （Х^2 Value was 19.22, 17.25, 7.97 and 5.38, respectively, all P 〈 0.05 ）, but the incidence rate of hypoglycemia in mild asphyxia group at different hours of age was higher than that in severe asphyxia group （Х^2 value was 18.21, 12.58, 6.29 and 5.18, respectively, all P 〈 0. 05）. The more severe the asphyxia was, the higher number of abnormal blood glucose and abnormal rate. With the increasing of hours of age and treatment, abnormality and abnormal rate of blood glucose in three groups decreased progressively. Conclusion Disorder of glucose metabolism can occur in neonatal asphyxia, thus strengthening early blood glucose monitoring in neonates with asphyxia is very valuable in judging severity, guiding treatment and improving prognosis.