摘要
目的：探讨足月儿和早产儿出生后排尿方式的不同以及排尿是否伴随大脑皮质觉醒。方法选取2013年5月至9月在郑州大学第一附属医院新生儿重症监护室（NICU）住院的31例足月儿[男20例，女11例，孕龄（38.2±1.2）周，体质量（3.3±0.4）kg，日龄4~16（10.5±3.6）d]和33例早产儿[男19例，女14例，孕龄（32.1±1.6）周，体质量（1.7±0.3）kg，日龄4~16（11.2±3.1）d]。新生儿均配带动态脑电图及心电监护。观察新生儿在4 h 内（早上8点至12点）自由排尿情况，记录2组新生儿每次排尿量、残余尿量、排尿次数、肢体活动及液体总入量以及排尿开始前后5 s 及排尿开始前后30 s 脑电图、呼吸频率和心率的变化。皮质觉醒定义使用国际儿科觉醒工作组制定的标准。结果共记录184次排尿。其中早产儿每次排尿量、肢体活动百分比分别为（21.8±7.9）mL 和（41±21）%，显著小于足月儿[（26.4±8.7）mL 和（62±19）%]（t =3.75、4.20，P 均﹤0.05）；而早产儿残余尿量和排尿次数分别为（1.7±0.9）mL 和（3.2±1.1）次，显著大于足月儿[（1.2±0.7）mL 和（2.6±0.9）次]（t =2.47、2.38，P 均﹤0.05）。2组新生儿排尿均发生在静态睡眠期（QS）；足月儿心率在排尿开始前后5 s 分别为（152±6）次/ min 和（152±5）次/ min，高于排尿开始前30 s[（147±6）次/ min]（t =5.30、5.76，P 均﹤0.05）。脑电图频率在排尿开始前后5 s 分别为（2.6±0.1）Hz 和（2.6±0.1） Hz，高于排尿开始前30 s[（1.5±0.1）Hz]（t =70.0、70.0，P 均﹤0.05）。早产儿排尿开始前后5 s 心率、脑电图频率与排尿开始前30 s 比较差异无统计学意义（P ﹥0.05）。2组新生儿呼吸频率在排尿开始前后均无明显改变（P ﹥0.05）。结论足月儿和早产儿排尿方式明显不同，足月儿排尿多伴大脑皮质的觉醒，而早产儿不伴大脑皮质觉醒，提示早产儿的膀胱功能及其
Objective To investigate the voiding patterns of term and preterm newborns and whether voiding in term and preterm neonates was accompanied by any cortical arousal. Methods Between May 2013 and September 2013,64 hospitalized newborns at Neonatal Intensive Cave Unit in the Frist Affiliated Hospital of Zhengzhou University were recruited in this study. In these patients,31 cases were term newborns（20 male,11 female）and 33 cases were preterm newborns（19 male,14 female）. The term and preterm newborns gestational ages at birth were（38. 2 ± 1. 2） weeks and（32. 1 ± 1. 6）weeks,weighted（3. 3 ± 0. 4）kg and（1. 7 ± 0. 3）kg,respectively and postnatal ages at study were[4 - 16（10. 5 ± 3. 6）]days and[4 - 16（11. 2 ± 3. 1）]days. The voiding volume（VV）,post - void residual volumes（PRV）,body movement rate and voiding frequency（VF）in 4 hours as well as the volume of milk and liquid fed at the same time frame were recorded and analyzed,retrospectively. At the same time electrocardiogram（ECG）and electroencephalogram（EEG）were recorded. The changes of heart rate（HR）,EEG frequency,respiratory frequency （RF）during the 5 s period and 30 s before and after voiding onset were compared respectively. For cortical arousal definition the recommendations of the International Pediatric Work Group on Arousals（2005）were used. Results A total of 184 times of voiding were recorded. In preterm newborns,the VV and body movements rate were significantly lower compared with the term newborns[（21. 8 ± 7. 9）mL and（41 ± 21）% vs（26. 4 ± 8. 7）mL and（62 ± 19）% , t = 3. 75,4. 20,all P ﹤ 0. 05]. However,the VF and PRV were significantly higher in preterm newborns[（1. 7 ± 0. 9） mL and（3. 2 ± 1. 1）times vs（1. 2 ± 0. 7）mL and（2. 6 ± 0. 9）times,t = 2. 47,2. 38,all P ﹤ 0. 05]. Bladder voiding in these infants happened only during QS. In term newborns,HR frequency was higher during the 5 s interval before and after voiding onset when compared with the 30 s
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2015年第14期1069-1071,共3页
Chinese Journal of Applied Clinical Pediatrics
基金
国家自然科学基金（81370869）
郑州市科技局资助项目（131PLJRC657）
关键词
婴儿
新生
排尿
皮质觉醒
Infant,newborn
Voiding
Cortical arousal
