窒息新生儿的血糖变化及护理对策

Blood sugar change in choked newborns and nursing strategies

目的 研究窒息新生儿 72h内血糖的变化情况和相应的护理对策。方法 采用微量血糖计对实验组 58例窒息新生儿和对照组 58例正常新生儿 ,在出生 72h内分 4个时间段分别测量两组新生儿的血糖。结果 窒息新生儿在 0～ 6h内血糖值为 9.2 2mmol/L ,在 1 3～ 2 4h内为 1 .86mmol/L ,血糖值变动较大分别表现为高血糖和低血糖症状 ,在 7～ 1 2h和 2 5～ 72h内血糖值与正常新生儿无差别。结论 针对窒息新生儿不同时间段血糖变化的特点 ,要采取①加强对血糖的监测 ,尤其是在 72h内 ,必要时可 q2h测血糖。②由于在临床中低血糖与高血糖均无特征性的表现 ,所以要加强对窒息新生儿的病情观察。③在复苏时推注高浓度的葡萄糖 ,对复苏无益 ,反而增加内环境的紊乱 ,应予摒弃。在输液时应严格控制输液速度 ,一般不超过 6～ 8ml/kg .min。④及早喂奶。⑤去除病因 ,纠正缺氧及水。

Objective To investigate choked newborns' level of blood sugar within 72 hours after birth and the corresponding nursing measures. Methods every choked newborn's level of blood sugar within 72 hours after birth was measured with mini blood sugar scale instrument. The study group included 58 cases of choked newborns, the control group included 58 cases of normal newborns. Results The level of blood sugar of choked newborn was 9 22 mmol/l within 6 hours after birth, 1.86 mmol/l from 13 to 24 hours after birth, which represented hypoglycemia and hyperglycemia respectively. There was no significant difference between the level of blood sugar from 7 to 12 hours after birth and the level of blood sugar from 25～72 hours after birth. Conclusions In view of the different characteristics of blood sugar level of choked newborns at different time, we should take different nursing measures to improve the life quality of newborns which include:① intensify the monitoring of blood sugar level, especially within 72 hours after birth, and measure the blood sugar level every two hours if necessary;② observe the state of illness closely because no characteristics representation can be seen from hypoglycemia and hyperglycemia; ③ it was not beneficial to inject high concentration glucose to newborns during resuscitation; ④ suckle the newborn as early as possible; ⑤ try to improve anoxia and keep the balance of water and electrolyte.