摘要
目的探讨新生儿缺氧缺血性脑病(HIE)出生早期血清电解质、血乳酸与新生儿行为神经测定的关系,早期识别新生儿缺氧缺血性脑病脑损伤程度,有利于正确进行治疗及早期干预,降低新生儿缺氧缺血性脑病所引发中枢神经系统的后遗症。方法新生儿缺氧缺血性脑病患儿76例,进行临床分度(轻、中、重度)。入院1h内进行外周动脉血气分析,测血乳酸,入院12h内测血清钙、钠、钾、氯。生后10～14d行新生儿行为神经测定(NBNA),NBNA> 35分为预后良好,≤35分为预后不良。选取同期住院36例新生儿肺炎患儿为对照组。对血清电解质、血乳酸与NBNA评分进行临床分析。结果 HIE组与对照组患儿血清钙、氯浓度及血乳酸比较,差异有显著性(P <0. 01),血清钠、钾浓度比较,P> 0. 05。HIE组患儿血清钙与NBNA评分呈正相关(r=0. 278,P <0. 01),各HIE组患儿血清氯与NBNA评分呈正相关(r=0. 263,P <0. 01),各HIE组患儿血乳酸与NBNA评分呈负相关(r=-0. 588,P <0. 01)。结论血清钙、血清氯、血乳酸能够较早识别新生儿缺氧缺血性脑病脑损伤程度,早期测定血清电解质及血乳酸,可进行有目的地指导治疗,降低HIE所引发的中枢神经系统后遗症。
Objective To investigate the relationship between serum electrolyte,blood lactate acid and neonatal behavioral neuropathy in newborn hypoxic ischemic encephalopathy,and recognize neonatal hypoxic ischemic encephalopathy in the early stage,which is conducive to correct treatment and early intervention and reduce the sequelae of the central nervous system caused by hypoxic ischemic encephalopathy. Methods Seventy-six cases of neonates with HIE were included and divided into groups according to their clinical features.Peripheral arterial blood gas analysis was performed within 1 hour of admission. Serum calcium,sodium,potassium and chlorine were measured within 12 hours of admission. Neonatal behavioral neurological assessment was done at 10 th ~ 14 th day after birth. Thirty-six cases of neonatal pneumonia were selected as control group. The serum electrolyte,blood lactate and NBNA score were analyzed clinically. Results There were significant difference in serum calcium,chlorine and blood lactic acid between the HIE group and control group( P < 0. 01),but there was no significant difference in serum natrium and potassium between the two groups( P > 0. 05). Serum calcium in HIE group was significantly positively corrected with NBNA score( P < 0. 01). Also,serum chlorine in HIE group was significantly positively corrected with NBNA score( r = 0. 263,P < 0. 01). But,blood lactic acid in HIE group was negatively corrected with NBNA score( r =-0. 588,P < 0. 01).Conclusions Serum calcium,serum chlorine and blood lactic acid can identify the brain injury degree of neonatal hypoxic-ischemic encephalopathy in the early stage. Early determination of serum electrolyte and blood lactic acid can be used to guide the treatment and reduce the sequelae of the central nervous system caused by HIE purposefully.
作者
王玉雯
臧丽娇
董淑祯
安丽
WANG Yuwen;ZANG Lijiao;DONG Shuzhen;AN Li(Clinical Medical College,Weifang Medical University,Weifang 261053,China;Department of Paediatrics,Jinan Central Hospital Affiliated to Shandong University)
出处
《潍坊医学院学报》
2018年第6期447-449,共3页
Acta Academiae Medicinae Weifang
