新生儿低血糖症34例资料分析

[目的]探讨新生儿低血糖的危险因素及临床特点,为诊治提供依据。[方法]对2005年8月至2008年4月贵港市妇幼保健院住院新生儿第一诊断为新生儿低血糖症的病例进行分析。[结果]共调查归档电子病案2 096例,第一诊断为新生儿低血糖症34例。34例新生儿低血糖症中,婴儿情况前5位依次是新生儿高胆红素血症、代谢性酸中毒、低体温、新生儿肺炎、低蛋白血症;母亲情况前5位依次是无异常、胎膜早破、妊高征、宫内窘迫、胎位不正;临床表现前5位依次是精神反应差、拒奶吃奶差、紫绀、无症状、哭声弱;经10%葡萄糖2 ml/kg静脉缓注,后予10%-12.5%葡萄糖按6-8 mg/kg.min静脉点滴治疗,30例痊愈、4例好转。[结论]对住院新生儿入院时监测血糖,及时发现低血糖,及时静脉输注葡萄糖纠正,大多预后良好。     

新生儿低血糖76例临床分析

目的探讨引起新生儿低血糖的危险因素及临床特点。方法对住院新生儿562例进行血糖监测。结果检出低血糖76例,发生率13.52%。其中早产儿及小于胎龄儿30.26%,窒息22.37%,感染17.11%,喂养不当11.84%,巨大儿7.89%,母婴ABO血型不合溶血病3.95%,糖尿病母亲婴儿3.95%,肺透明膜2.63%。结论早产儿、小于胎龄儿、窒息、感染、喂养不当、巨大儿等为新生儿低血糖的高危因素,应对其进行血糖监测并及时处理,以减少或避免后遗症的发生。     

新生儿低血糖36例诊治体会

目的 探讨新生儿低血糖的危险因素及临床特点.方法 对存在低血糖高危因素的新生儿110例进行血糖监测.结果 检出低血糖36例,临床症状多不典型,且无特异性.因窒息而发生低血糖经上述处理后,多于12～24 h内恢复正常,最长56 h;早产儿、小于胎龄儿、喂养困难所致者经上述处理后,多于8～18 h恢复正常;糖尿病母亲娩出儿经上述处理后于24～42 h血糖正常;溶血、感染者发生低血糖,多于16～28 h恢复正常.结论 对于有低血糖高危因素的新生儿要检测血糖,及时发现,及时纠正,避免低血糖引起神经系统损伤.     

新生儿低血糖58例临床及病因分析

目的:探讨引起新生儿低血糖的高危因素及临床特点。方法:对647例新生儿于入院时常规进行血糖检测。结果:检出低血糖58例,总发生率为9·0%。其中早产儿及小于胎龄儿18例(31·0%),窒息13例(22·4%),感染8例(13·8%),黄疸5例(8·6%),糖尿病母亲婴儿8例(13·8%),喂养困难2例(3·4%),红细胞增多症2例(3·4%),母亲合并妊高征2例(3·4%)。早产儿与足月儿低血糖发生率比较,差异有显著性(χ2=14·95,P<0·01),低出生体重儿、巨大儿低血糖发生率明显高于正常出生体重儿,差异均有显著性(χ2=16·83,P<0·01;χ2=18·84,P<0·01)。结论:凡糖尿病母亲婴儿、窒息、早产及小于胎龄儿、巨大儿等高危儿,生后均应严密监测血糖,并尽早开奶,加强喂养。治疗过程中,早产儿及小于胎龄儿血糖恢复正常后,应减慢葡萄糖的输注速度或降低其浓度,以避免发生高血糖。     

新生儿低血糖症49例临床分析

目的:探讨新生儿低血糖症的诱发因素和特点,为制定干预措施提供临床防治依据。方法:对528例新生儿入院后用微量血糖测试仪进行血糖检测。结果:检出的49例低血糖症,早产儿发生率和足月儿、过期产儿比较有统计学差异(P<0.01);低出生体重儿低血糖发生率和正常出生体重儿比较,差异有统计学意义(P<0.01);母亲患有糖尿病或妊娠期高血压疾病、围生期窒息、早产儿及小于胎龄儿、单纯喂养困难儿低血糖症发生率较高,分别为16.67%、14.55%、25.44%、15.38%;感染性疾病患儿发生率8.62%。结论:新生儿低血糖的发生主要与胎龄、出生体重、高危母亲、围生期窒息、喂养困难等因素有关;对存在低血糖危险因素的新生儿,均应早期监测血糖,并尽早喂养或鼻饲。     

早产儿发生低血糖的危险因素分析

目的 探究早产儿出生后发生低血糖的危险因素,为早产儿低血糖的预防和管理提供资料。方法 回顾536例胎龄<37周的早产儿临床资料,统计发生低血糖(血糖低于2.2 mol/L)的病例数,比较低血糖组和正常组的临床资料差异,运用Logistic回归模型分析早产儿发生低血糖的危险因素。结果 536例早产儿发生低血糖82例,发生率为15.3%。低血糖组早产儿的胎龄、出生体重低于正常组,小于胎龄儿(SGA)、剖宫产、出生体温<36.5℃、妊娠期甲状腺功能减退、妊娠期糖尿病、妊娠期高血压的比例高于正常组,差异均有统计学意义(P<0.05)。Logistic回归分析显示,SGA(OR=1.401)、妊娠期糖尿病(OR=2.746)、妊娠期高血压(OR=1.525)、出生低体温(OR=2.110)为早产儿低血糖的危险因素,阴道分娩(OR=0.596)为早产儿低血糖的保护因素,均P<0.05。结论 SGA、出生低体温、妊娠期高血压、妊娠期糖尿病可增加早产儿低血糖的发生风险,阴道分娩能够降低早产儿低血糖的发生风险。     

极低出生体重儿和/或胎龄小于32周早产儿入院低体温发生的危险因素分析

目的 分析极低出生体重儿和/或胎龄小于32周早产儿入院体温的分布情况及低体温发生的危险因素,为降低入院低体温的发生率提供理论依据。方法 选取2019年1月1日-2020年12月31日聊城市人民医院出生的极低出生体重儿(出生体重＜1 500 g)和/或胎龄＜32周早产儿共248例为研究对象;根据入院体温分为正常体温组(入院体温为36.5℃～37.5℃)122例、轻度低体温组(入院体温为36.0℃～36.4℃)98例、中度低体温组(入院体温为32.0℃～35.9℃)27例,记录三组病例的入院体温、一般资料及围生期资料,并进行统计分析。 结果 248例极低出生体重儿和/或胎龄小于32周早产儿,入院体温波动于34.8℃～38.0℃,平均体温(36.37±0.44)℃。单因素分析及组间比较结果显示,中度低体温组胎龄、剖宫产比例小于正常体温组(H=12.316、χ²=7.739,P<0.05),出生时气管插管的比例大于正常体温组(χ²=22.907, P<0.05);中度低体温组和轻度低体温组出生体重小于正常体温组(H=26.060,P<0.05),5 min Apgar评分≤7分及窒息复苏的比例大于正常体温组(χ²= 27.594、23.879, P<0.05)。多因素Logistic回归分析结果显示,出生体重(OR=0.997, 95%CI:0.996～0.999)、多胎(OR=2.279, 95%CI:1.106～4.694)和窒息复苏(OR=3.265, 95%CI:1.209～8.819)为低体温的独立影响因素(P＜0.05)。结论 极低出生体重儿和/或胎龄小于32周早产儿低体温的发生与多种因素相关,其中出生体重、多胎和窒息复苏是导致低体温的独立危险因素,可通过持续质量改进方案降低其入院低体温的发生率。     

112例新生儿低血糖临床及病因分析

目的:探讨引起新生儿低血糖的危险因素及临床特点,为诊治提供依据。方法:对存在低血糖高危因素的新生儿386例进行血糖监测。结果:检出低血糖112例,临床症状多不典型,且无特异性,常见疾病为窒息41例(36.6%)、溶血6例(5.4%)、早产儿及小于胎龄儿31例(27.7%)、感染9例(8.0%)、母亲患糖尿病3例(2.7%)、喂养困难22例(19.6%)。结论:对于有低血糖高危因素的新生儿要监测血糖,及时发现,及时纠正,避免低血糖引起中枢神经系统损伤。     

新生儿低血糖87例临床病例分析

新生儿低血糖是早产儿、小于胎龄儿容易出现的疾病，该疾病的出现最容易导致新生儿窒息，新生儿窒息又可导致很多合并症的产生（如新生儿颅内出血，新生儿缺血缺氧性脑病等）。同时，由于该疾病在发病时无明显的临床症状．又容易造成和新生儿期的其它疾病相混淆，耽误该疾病的诊断：和治疗。在该疾病发生之时和反复发作之后，如不能早期诊断和及时治疗，将会造成多种新生儿合并症的产生（如新生儿窒息，新生儿颅内出血，新生儿缺血缺氧性脑病等），给这些新生儿未来的健康造成永久性损伤和严重的不良后果。近年来，我们通过对窒息的新生儿、早产儿及小于胎龄儿的早期临床观察和监测血糖变化，来诊断和治疗新生儿低血糖，临床体会如下。     

高危新生儿低血糖102例临床分析

目的探讨引进新生儿低血糖的危险因素,为诊治提供依据。方法对存在低血糖高危因素的新生儿256例进行血糖监测。结果检出低血糖102例,临床症状多不典型,且无特异性,常见疾病为窒息45例(44.1%),早产儿及小于胎龄儿32例(31.4%),母亲患糖尿病11例(10.8%),感染10例(9.8%),硬肿症4例(3.9%)。结论对于有低血糖高危因素的新生儿要监测血糖,及时发现,及时纠正,避免低血糖引起中枢神经系统损伤。     

喂养方式对6个月内婴儿体格发育的影响研究

【目的】了解不同喂养方式对0~6月龄婴儿体格发育的影响作用。【方法】采用分层随机抽样的方法,在陕西彬县、长武两县随机抽取健康单胎新生儿及其家庭,进行问卷调查和体格检查,以体格测量方法评价婴儿营养状况。【结果】1 249例婴儿及其家庭参加调查,婴儿母乳喂养率为97.28%,4个月内纯母乳喂养率为65.49%;4个月内纯母乳喂养婴儿体重、身长、上臂围在1、3、6月龄时均显著高于混合喂养和人工喂养婴儿(P<0.05);纯母乳喂养婴儿各种疾病患病率在1、3、6月龄时均显著低于非纯母乳喂养婴儿(P<0.05)。【结论】母乳是婴儿最适宜的食品,能完全满足4~6月内婴儿的生长发育需求。普及科学喂养知识,提倡母乳喂养,将有助于提高当地婴儿的体格发育水平。     

Infant motor development and equipment use in the home

Forty-three mother-infant dyads were recruited to determine the relationship between both total equipment use and the use of individual pieces of equipment and infant motor development. At 8 months of age, total and individual equipment use was determined by parental survey and infant motor development was assessed using the Alberta Infant Motor Scale. Statistically significant correlations were found for the relationships between total equipment use and infant motor development (r = -0.50, P = 0.001) and individual pieces of equipment [exersaucer (r = -0.58, P = 0.001), highchair (r = -0.32, P = 0.04), and infant seat (r = -0.32, P = 0.03)] and infant motor development. These findings suggest that infants who have high equipment use tend to score lower on infant motor development or that infants who have low equipment use tend to score higher on infant motor development. Limitations of this cross-sectional study make it difficult to determine causality between these constructs. If equipment use is found to be causally related to infant motor development and predictive of later motor development in a future prospective study, parental education emphasizing the moderate use of equipment within the home environment might be warranted.     

‘The best thing for the baby’: Mothers’ concepts and experiences related to promoting their infants’ health and development

Mothers and pregnant women in contemporary western societies are at the centre of a web of expert and lay discourses concerning the ways they should promote and protect the health and development of their foetuses and infants. This article reports the findings from an Australian study involving interviews with 60 mothers. The findings explore in detail four topics discussed in the interviews related to pregnancy and caring for young infants: disciplining the pregnant body; promoting infants’ health; immunisation; and promoting infants’ development. Itis concluded that the mothers were highly aware of their responsibilities in protecting their foetuses and infants from harm and promoting their health and development. They conceptualised the infant body as highly vulnerable and requiring protection from contamination. They therefore generally supported the idea of vaccination as a way of protecting their babies’ immature immune systems, but were also often ambivalent about it. The mothers were aware of the judgemental attitudes of others, including other mothers, towards their caring efforts and attempted to conform to the ideal of the ‘good mother’. The emotional dimensions of caring for infants and protecting their health are discussed in relation to the voluntary participation of mothers in conforming to societal expectations.     

不同胎龄婴幼儿智能发育状况的追踪研究

目的 通过追踪记录不同胎龄(26⁺¹~42⁺⁶周)婴幼儿的智能发育指标并进行比较分析,发现不同胎龄婴幼儿的智能发育规律。方法 选取2012-2014年间于佛山市妇幼保健院儿童保健科随访至2岁或以上的婴幼儿3 438例,根据胎龄把随访婴幼儿分为5组,使用《0~6岁儿童神经心理发育量表》对各组婴幼儿分别进行3、6、9、12、18、24月龄的神经心理发育测试,计算各组的发育商均值并比较分析。结果 极早产儿组的发育商于随访期间低于其他组别婴幼儿(P<0.05)。晚期早产儿组的发育商于18月龄及以后与各胎龄足月儿、过期产儿组比较,差异无统计学意义(P>0.05)。各胎龄足月儿、过期产儿组于6月龄及以后发育商比较,差异无统计学意义(P>0.05)。结论 极早产儿仍为智能发育障碍的主要人群,需积极采取相关手段提高其生命质量。     

新生儿败血症早期临床诊断

目的:探讨诊断新生儿败血症早期的临床首发症状及实验室依据,以益早期诊治。方法:对我院新生儿科2001年1月~2004年12月收治的416例败血症患儿进行回顾性分析,分为足月儿组及早产儿组,分别对其发病时间、感染途径、临床首发症状及实验室检查等方面进行对比。结果:两组均以生后7日后发生率高;感染途径足月儿以皮肤、脐部为主,早产儿以呼吸道为主;临床表现上足月儿组首发症状依次为发热、纳少、皮肤黄疸、反应差。而早产儿组以体温波动、纳少、皮肤黄疸、腹胀及呼吸暂停为首发症状;早期的实验室检查以中性粒细胞与C反应蛋白(简称CRP)增高、血小板减少、以及血糖的变化对临床早期诊治较有意义。结论:新生儿临床败血症应注意早期反复发热或体温波动、纳少、皮肤黄疸、反应差等隐匿的中毒症状,并且结合入院周围血象、CRP、血糖及感染途径进行综合分析,对早期的诊治有指导意义。     

Biochemical Differences Between Preterm And Term Milk

As determined by 24-hour milk collections made during the first four weeks of lactation, preterm milk had a higher protein and sodium concentration and a lower calcium and phosphate content than term milk.     

Addition of Supplementary Foods and Infant Growth (2 to 24 Months)

Objective: To determine the effect of adding supplementary foods on infant growth 2 to 8 and 12 to 24 months.

Methods: Length (cm/month) and weight (kg/month) of white infants (n = 94) were measured five to nine times from 2 to 24 months of age. Mothers reported birth weights, infants’ ages at first introduction of supplementary food, illnesses and information sources about infant feeding. Simple linear regression equations were used to compute slopes for each child (unit changes in length and in weight by age). Stepwise linear regression was used to determine the effect on weight and length slopes by the introduction of supplementary foods (e.g., an infant’s age when cereal, fruit, juice, vegetables and a meat cluster were first added) to the diet. Breast feeding (months duration or ever fed), illness scores and gender were covariates in the regression models.

Results: A significant model (F = 10.09, p = .002) for weight gain (2 to 8 months) showed that gender explained 10% of the variance; for length slope, the model was non-significant and gender explained 3% of the variance. Females had a slower weight gain compared to that of males. None of the covariates or supplementary foods were retained in the models. Weight prior to 12 months was the best predictor (p = .0001, 54% of the variance) of weight gain 12 to 24 months.

Conclusions: Unit changes in weight or length for an infant’s age were not statistically associated with the timing of when supplementary foods were first added to the diet 2 to 8 or 12 to 24 months. Weight prior to 12 months was a significant predictor of weight gain 12 to 24 months.     

晚期早产儿和足月儿早期运动发育对照研究

目的研究晚期早产儿(在校正月龄后)和同龄足月儿早期运动发育水平的差异,为早期实施针对性的运动干预方案提供依据。方法选取2013年6月-2014年5月在本院出生并在门诊随访的晚期早产儿46例作为观察组,随机选择同时期在本院出生的健康足月儿50例为对照组。在两组婴儿(14.0±1.0)周龄运用Alberta婴儿运动量表(Alberta Infant Motor Scale,AIMS)进行运动发育评估,比较两组原始得分、百分位≥50%的比例和运动发育异常率。结果晚期早产儿AIMS原始得分低于足月儿组,但两组差异无统计学意义(P0.05);两组AIMS得分相对应的百分位≥50%的比例,晚期早产儿显著低于足月儿(P0.01)。晚期早产儿和足月儿运动发育异常的比例两组比较差异有统计学意义(P0.05)。结论晚期早产儿的早期运动发育趋势在校正胎龄后还常落后于正常足月出生同龄婴儿,应尽早实施早期干预,促进早产儿的良好发育。     

Infant nutrition – protein and its influence on growth rate

Breastfeeding provides the optimum nutrition for young infants and one of the aims of the new UK‐World Health Organization growth charts is to encourage healthcare professionals and parents to see breastfed infants' growth rate as the norm. Formula‐fed infants gain weight more quickly than breastfed infants in the first year of life, and this may be because of the greater quantity of protein in infant formula. Childhood obesity rates are increasing and obesity is probably the result of a multitude of factors. Observational studies have indicated that rapid growth in infancy may contribute to a later risk of obesity. New randomised controlled studies have shown that lower protein levels in infant formula can slow infants' weight gain, and this may offer short‐ and long‐term health benefits. New innovations in protein quality now allow reductions in the total protein content of infant formula.     

1560例2岁以下门诊小儿血红蛋白值的观察

<正> 儿童期的缺铁性贫血是多发病之一,尤以3岁以下发病率最高,不仅影响小儿体格发育,甚至影响智能发育。WHO公布6月至6岁小儿血红蛋白值(下称Hb)<11g为贫血诊断标准。经全国性会议讨论认为此标准也适用于我国。笔者就我院2岁以下门诊就诊小儿的Hb值作为观察内容,以了解我区贫血的发生情况。 一、资料来源及方法 资料选自我院门诊就诊的小儿。1983年5月至11月止,收集2岁以下小儿为观察对象(包括新生儿在内)共1560例,病例选择以上呼吸道感染起病,病程在1至2天内者或健康体检者。对有腹泻,呕吐及