新生儿缺氧缺血性脑病内环境紊乱的临床研究

A clinical study on internal milieu disorder in newborn infants suffered with hy poxic ischemic encephalopathy

目的 探讨新生儿缺氧缺血性脑病 (HIE)患儿血糖 (blood sugar,BS)、血清钾、钠、钙的变化及其相互关系 ;并探索其与病情发展的关系。方法 对 12 0例 HIE患儿进行血糖及血清钾、钠、钙的动态检测 ,并依病情轻重进行分组分析。结果 HIE患儿易于发生应激性高血糖 (SHG)、低钠血症 (HN)、高钾血症、低钙血症 (HC) ;且病情愈重 SHG、HN、HC及高钾血症的发生率愈高 ,程度愈重 ;血糖、血钾的升高 ,血钠、血钙的降低与病情轻重及预后关系密切 ;也是反映危重情况的临床指标 ,而存活者随 HIE进入恢复期 ,上述指标逐渐恢复正常。结论 HIE患儿存在血糖及血清电解质多种改变 ,且与病情发展及转归关系密切。故在 HIE治疗中注意控制过度应激反应 。

Objective To explore the changes and relationship be tween blood sugar and serum electrolyte on the development (or prognosis) of hyp oxic ischemic encephalopathy(HIE)in newborn infants.Methods We detected dynamic changes of 4 indexes in 120 hospitalized pediatric patients who suffered from HIE.The detected items include blood glucose, serum K +,Na + as well as blood calcium.Meanwhile a comparative analysis was done between differe nt groups divided according to the severity of the illness.Results Newborn infants who involved in HIE constantly turned up hyperglycemia,hypon atremia,hypocalcemia and hyperkalemia.The more severe the disease was,the more hyperglycemia,hyponatremi a,hypocalcemia or hyperkalemia happened, and the more serious their levels were. Our results demonstrated that these four circumstances were indicators of sever ity of the disease and they made the internal milieu out of balance more serious further. These indexes were restored progressively when HIE went better.Conclusion There really exist varied changes of blood sugar and serum electrolure in newborn infants suffered with HIE.It is noticed that there is a close correlation between hyperglycemia,hyponatremia,hypocalcemia,hyp erkalemia and the severity of the disease.It must be essential for these patients to control exce ssive stress and redress electrolyte disturbance correctly.