早期诊断治疗妊娠糖尿病母亲新生儿合并缺氧缺血性脑病对其预后的影响

Early diagnosis treatment of gestational diabetes mellitus mother newborn with hypoxic ischemic encephalopathy affect its prognosis

目的妊娠糖尿病(gestational diabetes mellitus,GDM)母亲新生儿发生缺氧缺血性脑病(Hypoxicischemic Encephalopathy,HIE)的临床相关性及早期诊断治疗预防后遗症的价值。方法收治妊娠糖尿病患者100例,无其他疾病健康孕妇100例为对照组,对其分娩新生儿临床资料进行回顾性分析,并对于妊娠糖尿病母亲新生儿发生HIE患儿与未出现HIE患儿血电解质、血糖、心肌酶谱、肝功、肾功指标进行比较分析,对于HIE患儿给予神经节苷脂早期干预,随访一年。结果妊娠糖尿病母亲新生儿发生缺氧缺血性脑病概率为18%,与对照组,概率2%比较,差异有统计学意义(P<0.01),妊娠糖尿病母亲新生儿发生HIE后血生化指标CK、CK-MB、LDH、AST、ALT、GLU、UA、BUN明显升高,血钾降低,差异均有统计学意义,对于早期干预治疗,后遗症发生率明显降低。结论妊娠糖尿病母亲新生儿发生HIE机率较高,出现HIE患儿肝功、肾功、心肌酶、脑细胞有不同程度损伤,早期发现、早期治疗,对于预防发生HIE,并减少后遗症有重要意义。

Objective To explore the clinical relevance of hypoxic ischemic encephalopathy （HIE） and the value of early diagnosis and treatment sequelae of neonatal diabetes mellitus （GDM）. Methods 100 patients with gestational diabetes mellitus were treated,and 100 patients with no other disease were treated as control group,all the clinical data of neonatal and neonatal infants were retrospectively analyzed.And blood electrolyte,blood sugar,myocardial enzymes,hepatic function, renal function indexes of gestational diabetes not present children with HIE mother newborn children with HIE were comparative analyzed,children with HIE ganglioside were given early intervention,and follow-up of one year. Results The incidence of hypoxic ischemic encephalopathy was 18% in neonates with gestational diabetes.Compared with the control group（2%）,the difference was statistically significant （P 〈 0.01）. The blood biochemical index CK,CK-MB,LDH,AST,ALT,GLU,UA and BUN were significantly increased after neonatal diabetes,the difference was statistically significant.For early intervention treatment,the incidence of sequelae was significantly reduced. Conclusion Gestational diabetes mother newborns with HIE probability is higher,in children with HIE hepatic function,renal function,myocardial enzyme,brain cells,damage to different extent,early discovery,early treatment,for the prevention of HIE,and reduce the complications.