新生儿黄疸时胆红素、心肌酶变化

新生儿黄疸分为生理性黄疸和病理性黄疸,病理性黄疸又分为肝细胞前性黄疸、肝细胞性黄疸、肝细胞后性黄疸.根据新生儿高胆红素血症的诊断,经皮胆红素（TCB）〉220.6 μmol/L诊断为新生儿高胆红素血症[1],在此仅就我院近3年来生理性黄疸及病理性黄疸中肝细胞前性黄疸及肝细胞后性黄疸患儿的胆红素、心肌酶变化特点分析如下.     

新生儿呕吐、腹泻、腹胀原因分析

对临床新生儿呕吐、腹泻、腹胀原因进行分析。通过采取回顾及跟踪调查方式进行登记统计并加以分析找到引起新生儿呕吐、腹泻、腹胀的主要因素进行有的放矢的治疗预防。通过临床上对156例新生儿出现呕吐、腹泻、腹胀原因调查研究掌握其规律可防性。掌握新生儿呕吐、腹泻、腹胀对患儿的治疗有其针对性,有利于患儿早日康复,不致使患儿的健康发育受到影响。     

新生儿游泳与新生儿生长发育的关系

目的探讨新生儿游泳与新生儿生长发育的关系。方法选取2009年6月至2012年5月于本院出生的320例新生儿做为研究对象,经家长同意,将其分为观察组(游泳组)160例和对照组(非游泳组)160例,后将两组新生儿的生长发育情况进行统计及比较。结果观察组的新生儿生长发育情况优于对照组,均有显著性差异。结论新生儿游泳可以促进新生儿各系统的生长发育,值得在临床推广应用。     

新生儿游泳对新生儿体重、睡眠及黄疸的影响

新生儿游泳又称新生儿泳疗,是一项特别的、健康的、新型的新生儿保健活动.它是指在特定的环境、条件下让大量温和良好的水经过对皮肤、外围血管的拍击、安抚作用而产生一系列良性的反应,开展新生儿游泳的护理体会报告如下. 1 资料与方法 1.1 一般资料选择2009年1月至9月在我院出生的新生儿260例,根据家属意愿分为游泳组和对照组,每组130例,2组新生儿均为正常足月新生儿,Apgar评分9～10分,且无并发症和合并症,无特殊治疗.     

新生儿、儿童、老年人临终关怀护理特点分析

临终关怀是近年来新兴的一门边缘学科，突出的特点是护理重于治疗，即重点不在于治疗，而是心理和社会等多方面的护理，以期减轻患者病痛、延缓疾病发展，使临终患者的内心得到释放、生活质量得到提高、生命得到尊重，最终能安详地度过人生的最后阶段，也使家属的精神健康得以维护。临终患者的年龄不同，所需的临终关怀也具有不同的特点。     

窒息新生儿血浆NO、SOD、MDA水平分析

新生儿缺氧缺血性脑病（HIE）致病机制复杂,但主要是由于窒息缺氧导致血管调节障碍和脑血流减少等原因引起。一氧化氮（NO）作为血管舒缩调节因子,在脑缺血或脑缺血再灌注损伤中具有保护作用及毒性作用。本观察30例窒息新生儿NO与超氧化物歧化酶（SOD）和丙二醛（MDA）水平,并与正常新生儿相比较,报道如下。     

新生儿游泳治疗新生儿红斑的疗效观察

目的:探讨新生儿游泳对治疗新生儿红斑及脓疱疮的疗效。方法:将51例新生儿红斑患儿随机分成实验组及对照组,实验组26例,对照组25例,两组患儿每日均进行温水洗浴,除此外观察组实验组由具有水疗资格的护士帮助新生儿游泳,数天后观察两组新生儿红斑的消退情况。结果:实验组23例痊愈,好转3例,有效率100%。对照组15例痊愈,好转6例,发生脓疱疮的4例,有效率84%,两组比较,具有显著性差异(P<0.05)。实验组的红斑消退天数为(4.01±1.12)d,对照组为(6.93±2.78)d,两组比较,差异有统计学意义(P<0.01)。结论:新生儿游泳能够治疗新生儿红斑,预防新生儿脓疱疮的发生,提高新生儿护理质量,值得推广。     

朝、汉不同民族新生儿脑电图探讨

目的探索朝、汉不同民族新生儿脑电图有无差异。方法选择胎龄37～42周,1～5minApgar评分8～10分,体质量2500～3999g,无围生期疾病,母亲健康的生后1～7d围生期新生儿。采用日本光电7314/F型脑电图机,按国际10/20系统法安放F1、F2、C3、C4、T3、T4、O1、O2、Cz、(参考电极),接地线等12个盘状电极,清醒、睁眼和闭眼状态下进行参考导联及双极导联描记。取参考导联,闭眼,基线稳定,无眼动伪差部分100cm,用指数测量仪测量各脑区δ和θ波频率,求其均值及标准差,波幅范围。结果朝、汉不同民族新生儿之间脑电图形式无显著性差异。结论国外报道种族间脑电图形式无显著性差异,本文朝,汉不同民族新生儿间脑电图形式与国外报道一致。     

新生儿疾病的高压氧治疗

新生儿疾病包括新生儿窒息、新生儿颅内出血、新生儿肺炎、新生儿硬肿症、破伤风等，是引起新生儿缺血缺氧性脑病和新生儿死亡的主要原因之一，也是造成新生儿智能和运动发育落后甚至终生残疾的重要原因。2002年3月-2004年5月临床应用高压氧治疗新生儿疾病66例取得了良好的效果。报告如下：     

Lidocaine treatment of neonatal convulsions,a therapeutic dilemma

Summary Three infants with neonatal convulsions were given lidocaine infusions for three days, three weeks and three months, respectively, and the plasma concentrations of lidocaine and its metabolites were analyzed by HPLC.After a prolonged infusion there was considerable accumulation of the metabolites.This may account for the difficulty of stopping the infusion without relapse of the seizures.     

血浆内皮素头颅CT及神经行为测定在新生儿缺氧缺血性脑病时的变化及意义

目的　探讨新生儿缺氧缺血性脑病 (HIE)时血浆内皮素 (ET)、头颅CT以及新生儿行为神经测定(NBNA)三项检测在不同时期的变化及其相互关系 ,评估此三项指标单一及相结合后对临床的指导意义。方法　放射免疫法检测HIE患者不同时期的血浆ET值 ,同时进行头颅CT及NBNA检测。结果　ET值的升高与临床中重度病情关系密切。而升高的持续时间可能与预后关系较大 ;头颅CT在早期与临床的符合率不足 70 % ,因而早期CT正常不能排除HIE ;NBNA测定结果则与HIE的临床经过基本一致 ,但其缺点是易受到新生儿状态的影响。结论　三种指标相结合可以更为有利于客观地判断病情 ,指导治疗和预后 ,进而有利于开展早期干预 ,减少致残     

Hyperalgesia, low-anxiety, and impairment of avoidance learning in neonatal caffeine-treated rats

Rationale The nonselective adenosine receptor antagonist caffeine is used clinically to treat apnea in preterm infants. The brain developmental stage of preterm infants is usually at a period of rapid brain growth, referred as brain growth spurt, which occurs during early postnatal life in rats and is highly sensitive to central nervous system (CNS) acting drugs. Objectives The aim of this work was to study whether caffeine treatment during brain growth spurt produces long-term effects on the adenosine receptor-regulated behaviors including nociception, anxiety, learning, and memory. Methods Neonatal male and female Sprague–Dawley rats were administered either deionized water or caffeine (15–20 mg kg⁻¹ day⁻¹) through gavage (0.05 ml/10 g) over postnatal days (PN) 2–6. The hot-plate test, elevated plus-maze, dark-light transition test, and step-through inhibitory avoidance learning task were examined in juvenile rats. Furthermore, the responses to adenosine A₁ receptor agonist N(6)-cyclopentyladenosine (CPA)-induced hypothermia and A_2A receptor agonist CGS21680-induced locomotor depression were also compared. Results Caffeine-treated rats showed hyperalgesia in hot-plate test, less anxiety than controls in the elevated plus-maze and dark–light transition, and impairment in step-through avoidance learning test. Moreover, the responses to CPA-induced hypothermia and CGS21680-induced locomotor depression were enhanced in caffeine-treated rats. Conclusion These results indicate that caffeine exposure during brain growth spurt alters the adenosine receptor-regulated behaviors and the responsiveness to adenosine agonists, suggesting the risk of adenosine receptor-related behavioral dysfunction may exist in preterm newborns treated for apnea with caffeine.     

新生儿行为神经测定在新生儿高胆红素血症中的临床应用

目的探讨对新生儿高胆红素血症患儿采用新生儿行为神经测定早期轻微脑损伤的临床应用效果。方法选取60例新生儿高胆红素血症患儿作为研究组,另选取同期60例正常新生儿作为参照组。研究组患儿分别于黄疸高峰期及消退期进行新生儿行为神经测定,并与参照组新生儿进行对比。结果研究组1患儿的新生儿行为神经测定评分为(33.8±4.9)分,研究组2患儿的新生儿行为神经测定评分为(36.9±1.8)分,对照组新生儿的新生儿行为神经测定评分为(39.2±0.5)分。研究组1、研究组2患儿的新生儿行为神经测定评分均明显低于对照组新生儿,差异具有统计学意义(P<0.05);研究组1患儿的新生儿行为神经测定评分低于研究组2,差异具有统计学意义(P<0.05)。观察组患儿黄疸高峰期新生儿行为神经测定评分(34.11±3.42)分低于黄疸消退期的(37.86±1.73)分,差异具有统计学意义(P<0.05)。结论高胆红素血症将会对新生儿的神经行为能力造成直接的影响,通过对新生儿采取新生儿行为神经测定可以及时地发现由高胆红素血症对新生儿造成的轻微脑部损伤,从而及早地对患儿进行干预,避免患儿出现严重的后果,具有临床推广意义。     

新生儿转运流程规范化对新生儿转运效果的评价

目的探讨新生儿转运流程规范化对新生儿转运效果的评价。方法选取2013年2月~2015年11月我院诊治的300例危重新生儿为研究对象,根据我院新生儿转运流程规范化前后分为观察组213例和对照组87例,对照组为新生儿转运流程规范化前,观察组为新生儿转运流程规范化后。结果观察组转运前处理时间及转运后安置时间均较对照组缩短,差异有统计学意义(P<0.05);观察组家属满意度为95.77%优于对照组(87.36%),差异有统计学意义(P<0.05);观察组转运不良事件发生率为2.82%较对照组(12.64%)低,差异有统计学意义(P<0.05)。结论规范化新生儿转运流程,能有效的缩短转运前及转运后处理时间,提高家属满意度,降低转运过程中不良事件的发生率。     

Functional maturation of drug transporters in the developing, neonatal, and postnatal kidney

Because renal function in newborns is immature, the pharmacokinetics of drugs administered to neonates vary significantly from adult patients. The establishment of drug transport systems is a key process in the functional maturation of the nephron. However, a thorough examination of the expression of the main drug transporters in the kidney throughout all stages of development (embryonic, postnatal, and mature) has yet to be carried out, and the functional (physiological) impact is not well understood. Using time-series microarray data, we analyzed the temporal behavior of mRNA levels for a wide range of SLC and ABC transporters in the rodent kidney throughout a developmental time series. We find dynamic increases between the postnatal and mature stages of development for a number of transporters, including the proximal tubule-specific drug and organic anion transporters (OATs) OAT1 (SLC22a6) and OAT3 (SLC22a8). The OATs are the major multispecific basolateral drug, toxin, and metabolite transporters in the proximal tubule responsible for handling of many drugs, as well as the prototypical OAT substrate para-aminohippurate (PAH). We therefore performed specific in vivo pharmacokinetic analysis of the transport of PAH in postnatal and maturing rodent kidney. We show that there is a 4-fold increase in PAH clearance during this period. Clearance studies in Oat1 and Oat3 knockouts confirm that, as in the adult, Oat1 is the principle transporter of PAH in the postnatal kidney. The substantial differences observed supports the need for better understanding of pharmacokinetics in the newborn and juvenile kidney compared with the adult kidney at the basic and clinical level.     

Distribution of bisphenol A into tissues of adult, neonatal, and fetal Sprague-Dawley rats

Bisphenol A (BPA) is an important industrial chemical used in the manufacture of polycarbonate plastic products and epoxy resin-based food can liners. The presence of BPA metabolites in urine of > 90% of Americans aged 6-60 suggests ubiquitous and frequent exposure in the range of 0.02-0.2 μg/kg bw/d (25th-95th percentiles). The current study used LC/MS/MS to measure placental transfer and concentrations of aglycone (receptor-active) and conjugated (inactive) BPA in tissues from Sprague-Dawley rats administered deuterated BPA (100 μg/kg bw) by oral and IV routes. In adult female rat tissues, the tissue/serum concentration ratios for aglycone BPA ranged from 0.7 in liver to 5 in adipose tissue, reflecting differences in tissue perfusion, composition, and metabolic capacity. Following IV administration to dams, placental transfer was observed for aglycone BPA into fetuses at several gestational days (GD), with fetal/maternal serum ratios of 2.7 at GD 12, 1.2 at GD 16, and 0.4 at GD 20; the corresponding ratios for conjugated BPA were 0.43, 0.65, and 3.7. These ratios were within the ranges observed in adult tissues and were not indicative of preferential accumulation of aglycone BPA or hydrolysis of conjugates in fetal tissue in vivo. Concentrations of aglycone BPA in GD 20 fetal brain were higher than in liver or serum. Oral administration of the same dose did not produce measurable levels of aglycone BPA in fetal tissues. Amniotic fluid consistently contained levels of BPA at or below those in maternal serum. Concentrations of aglycone BPA in tissues of neonatal rats decreased with age in a manner consistent with the corresponding circulating levels. Phase II metabolism of BPA increased with fetal age such that near-term fetus was similar to early post-natal rats. These results show that concentrations of aglycone BPA in fetal tissues are similar to those in other maternal and neonatal tissues and that maternal Phase II metabolism, especially following oral administration, and fetal age are critical in reducing exposures to the fetus.     

肺泡表面活性物质预防新生儿呼吸窘迫综合征的疗效

目的：探讨肺泡表面活性物质（PS）预防新生儿呼吸窘迫综合征（NRDS）的疗效及其安全性。方法：回顾性分析本院2008年2月～2010年10月收治入院的早产儿120例的临床资料,随机将120例早产儿分为研究组60例和对照组60例,研究组气管插管后气囊加压同时直接注入肺泡表面活性物质,注入后拨管,然后低流量吸氧支持治疗。对照组是呼吸机支持下注入肺泡表面活性物质,上机3～7d后拨管。观察两组NRDS发病率、并发症发生率和病死率。结果：研究组和对照组RDS发生率、CPAP使用率、并发症发生率及病死率与对照组比较差异均有统计学意义（P〈0.05）。结论：PS可明显减少NRDS的发生率,减少CPAP的使用及并发症的发生,改善患儿预后。呼吸机支持下注入肺泡表面活性物质的方式较好。