The association between serum triglycerides and gamma glutamyl transpeptidase activity in diabetes mellitus.

A study conducted on 228 diabetic patients has shown a significant positive association between serum gamma-glutamyl transpeptidase (GGT) and triglyceride levels. Both fall with treatment, the most marked reduction occurring in patients on insulin. We suggest that the association between serum GGT and triglyceride levels and also the higher incidence of raised GGT and triglyceride levels in new diabetics may reflect hepatic microsomal enzyme induction of the rate-limiting enzymes of triglyceride synthesis. Serum GGT does not seem to correlate with hepatomegaly in diabetes mellitus.     

Temperament in very low birth weight infants

This project compared the temperament of very low birth weight (VLBW) infants to that of full-term infants at 6 and 12 months of age, assessed patterns of change in temperament from 6 to 12 months, and investigated effects of the neonatal experience on manifestations of temperament in VLBW babies. The subjects were 41 VLBW infants who were free of congenital anomalies and appropriate for gestational age. Instruments included the Infant Temperament Questionnaire (ITQ), Toddler Temperament Questionnaire (TTQ), and the Home Observation for Measurement of the Environment (HOME) Inventory. At 6 months, the VLBW infants were significantly less adaptable and more intense than full-term infants. There were significantly more "difficult" and fewer "easy" infants in the study group. At 12 months, the infants were less persistent than a full-term toddler. Behavioral style clusters of the toddlers did not differ significantly from published data. Multiple regression analyses revealed that the social environment of the VLBW infant plays an important role in the manifestation of childhood temperament as early as 6 months of age. Results suggest that VLBW infants do manifest behavioral styles that are different from full-term infants but are modified during the first year of life. In addition, the nine temperament dimensions were differentially affected by adverse perinatal events and environmental factors.     

极低出生体重儿的营养护理

胎龄小于32周出生,体质量＜1500 g的早产儿称为极低出生体重儿(VLBWI),存活者后遗症发生率较其他早产儿更高.因VLBWI存在着营养上的缺陷,出生时营养储备少,容易患疾病,如新生儿呼吸窘迫综合征(RDS)、感染等.所以合理喂养对提高VLBWI的存活率至关重要.笔者对浙江大学医学院附属儿童医院NICU 2008年1月至2009年7月收住的110例VLBWI患儿的喂养护理情况进行总结,现报道如下.     

极低出生体重儿的营养护理

胎龄小于32周出生,体质量＜1500 g的早产儿称为极低出生体重儿(VLBWI),存活者后遗症发生率较其他早产儿更高.因VLBWI存在着营养上的缺陷,出生时营养储备少,容易患疾病,如新生儿呼吸窘迫综合征(RDS)、感染等.所以合理喂养对提高VLBWI的存活率至关重要.笔者对浙江大学医学院附属儿童医院NICU 2008年1月至2009年7月收住的110例VLBWI患儿的喂养护理情况进行总结,现报道如下.     

超低出生体重儿的呼吸道管理

超低出生体重儿(ELBWI)是指出生体质量＜1000 g的活产早产儿,其死亡率极高.国外报道,体质量≤750 g者存活率为44%,体质量751～1000 g者存活率为81%.     

极低出生体重儿转运过程中的护理

目的探讨极低出生儿体重儿转运过程中的有效护理措施，降低其死亡率。方法通过转运系统将基层医院32例极低出生体重儿转运至新生儿重症监护病房治疗，具体措施包括现场抢救，应用肺泡表面活性物质，途中连续监护和治疗。结果极低出生体重儿32例均成功转运，治愈出院13例，死亡19例，无一例途中死亡。结论全程监护，尽早转运及应用固尔苏是转运成功及降低极低出生体重儿死亡率的关键。     

Gentamicin dosing and pharmacokinetics in low birth weight infants

Monitoring of serum gentamicin concentrations and one-compartment pharmacokinetic analysis were performed in 41 preterm low birth weight infants (20 with birth weight of less than 1,500 g and 21 with birth weight of greater than or equal to 1,500 g) in the first week of life. Our dosing regimens, which were 2.0 mg/kg every 24 hr for the less than 1,500 g group and 2.0 mg/kg every 12 hr for the greater than or equal to 1,500 g group, successfully achieved the desired peak (4-8 micrograms/ml; 87.8%) and trough (less than or equal to 3 micrograms/ml; 97.5%) concentrations on the 4th day of treatment. In a one-compartment pharmacokinetic analysis, a large intersubject variability of pharmacokinetic parameters were observed on the 1st day of treatment. When we compared the parameters of the 1st day with those of the 4th day, apparent decreases in Vd and TBC were observed. The mean values for TBC and T1/2 or Kd of the two birth weight groups were significantly different from each other on the 4th day of treatment, suggesting a less maturity of renal functions in the less than 1,500 g group. The modified method of Sawchuk and Zaske was proven impractical in predicting steady-state serum concentrations because of an underestimation probably caused by the dramatic alteration of Vd due to a diuresis soon after birth. Based on these results, we recommend the above-described dosing regimen and emphasize the importance of a close monitoring of serum gentamicin concentrations and toxicities, instead of the individualized dosing approach in low birth weight infants in the first week of life.     

极低出生体重儿转运过程中的护理

目的 探讨极低出生儿体重儿转运过程中的有效护理措施,降低其死亡率.方法 通过转运系统将基层医院32例极低出生体重儿转运至新生儿重症监护病房治疗,具体措施包括现场抢救,应用肺泡表面活性物质,途中连续监护和治疗.结果 极低出生体重儿32例均成功转运,治愈出院13例,死亡19例,无一例途中死亡.结论 全程监护,尽早转运及应用固尔苏是转运成功及降低极低出生体重儿死亡率的关键.     

超低出生体重儿的早期护理干预

随着新生儿重症监护技术的不断发展,出生体质量<1 000g的超低出生体重儿(ELBWI)的存活率大大提高。ELBWI的存活不但取决于成功与周密的治疗方案,同时与周到细致、严谨、科学、充满爱心的护理密不可分。2009年5月—2011年3月共收治ELBWI 10例。现将护理体会总结如下。     

超低出生体重儿的早期护理干预

随着新生儿重症监护技术的不断发展,出生体质量〈1 000g的超低出生体重儿（ELBWI）的存活率大大提高。ELBWI的存活不但取决于成功与周密的治疗方案,同时与周到细致、严谨、科学、充满爱心的护理密不可分。2009年5月—2011年3月共收治ELBWI 10例。现将护理体会总结如下。     

发展性照顾对极低出生体重患儿体重的影响

目的探讨发展性照顾对极低出生体重患儿体重的影响。方法将200例极低出生体重患儿,按入院次序分为对照组和实验组,每组各100例,对照组采用常规护理方法,实验组在常规护理的基础上,实施发展性照顾。比较两组患儿在入院时、入院后7d和15d体重的差异。结果观察组患儿在入院后7d和15d,其体重增长优于对照组患儿,两组比较,均P<0.05,差异具有统计学意义。结论实施发展性照顾可提高极低出生体重患儿体重增长,从而增强患儿的生存能力。     

Nutritional influences on the growth of extremely low birth weight infants

Recent advances in the area of neonatal nutrition have contributed to the overall survival rate of extremely low birth weight preterm infants. However, the pathophysiologic conditions that affect these infants influences the overall nutrition plan and ultimately impacts their growth. This article discusses research findings related to the growth of extremely low birth weight infants and the relationship between growth and nutritional care practices. Copyright 2002, Elsevier Science (USA). All rights reserved.     

Single-breath measurement of lung mechanics in very low birth weight infants

The expiratory time constant of the respiratory system (Trs) and the total respiratory system compliance (Crs) were measured from the analysis of a flow-volume loop during relaxed expiration, and the total respiratory system resistance (Rrs) was derived from the relationship: Rrs = Trs/Crs. In ten intubated and mechanically ventilated very low birth weight infants, the values obtained for compliance (0.21 to 0.71 ml/cm H2O) were similar to those found using an occlusion technique during spontaneous breathing. The values of Trs were 0.03 to 0.14 sec. These Trs values were altered by adding known resistive loads. The corresponding derived values for Rrs were close to the values of the added resistance loads, suggesting that resistance values found in this group of ventilated babies (120 to 380 cm H2O/L X sec) were accurate.     

低出生体重儿生长发育状况及营养状况评价

目的 探讨住院低出生体重儿的生长发育情况。 方法 选取2011年1月1日-12月30日入住新生儿病房的90例低出生体重儿,对他们进行体重、身长、头围等监测。结果 出院时患儿体重增长速度10.1～15.5kg/d,出院时身长增长速度为1.1～1.2cm/周,平均身长(46.5±3.5)cm;头围的增长速度0.6～0.7cm/周,平均头围(31.5±1.5)cm;平均体重(2 300±290)g。患儿存在轻度和中度营养不良。 结论 低出生体重儿存在营养不良,其生长发育仍明显落后。