早产儿4h、8h和12h排尿方式比较

Comparison of four,eight and twelve hours voiding patterns in premature infant

目的分别用4h、8h和12h观察法观察早产儿出生早期的排尿方式，了解3种观察法结果有无差异。方法选取出生1～7d的早产儿32例。男17例，女15例；胎龄32～36^＋6（34．2±1．5）周；出生体质量1．2～3．6（2．1±0．6）kg。根据记录排尿时新生儿日龄分为7组（第1—7天组）。每个观察对象连续观察12h，分别对4h、8h和12h记录的排尿参数进行统计学分析。记录排尿参数包括排尿时间、排尿量、残余尿量、排尿时的意识状态（清醒／睡眠）、排尿次数等。结果共记录排尿617次。第1天组11例早产儿出生12h内排尿2～9（5．1±2．2）次，其中4例出生8h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有啼哭。7组早产儿12h内排尿次数差异无统计学意义，但均存在明显的间断排尿模式。第2天组、第4天组、第5天组和第6天组4h与12h排尿频率差异有统计学意义（P均〈0．01）；第4天组8h与12h差异有统计学意义（P〈0．05）。不同时段每次排尿量、残余尿量在所有组中差异均无统计学意义（P均〉0．05）。残余尿量个体变化大（0—30mL），次残余尿量随日龄变化不明显。结论用4h观察法可以推测出生7d内新生儿8h和12h内排尿量、残余尿量，但不能替代8h和12h观察法观察的排尿频率。

Objective To explore the possibility of using 4,8, and 12 hours voiding observation to evaluate the bladder function in early birth in premature infants, and understand the differences among the 3 observation methods. Methods A total of 32 premature infants were selected, 17 cases were male, 15 cases were female;their gestational age were 32 - 36^＋6 （34.2 ± 1.5 ） weeks ; their birth weight were 1.2 - 3.6 （2.1 ± 0.6） kg; and they were divided into 7 groups according to the day age. Free voiding pattern was recorded for 12 hours,and the parameters included voiding time （VT）, voiding volume （VV）, post-void residual volume （PRV）, state of consciousness at voiding, and voiding fre- quency（VF） per hour were recorded. The recorded voiding parameters of 4 hours were compared with those of 12 hours. Results A total of 617 times voiding cycles were recorded. Between different time schedules and groups, sig- nificant difference of VF per hour existed and significant difference of VV, PRV was not found. In day 1 group, 11 pa- tients were observed in the period starting from 12 h after birth, no voiding was found in 4 cases. From the 3^rd day after birth,the phenomenon was observed of these newborn＇s moving arms and/or legs or crying before voiding. Conclusion Four-hour observation can be used to determine the VV and PRV but not VF in the premature early newborn.