早产儿糖代谢紊乱的监测及分析

目的:研究早产儿糖代谢紊乱的监测方法、特点、危险因素。方法:采用静脉血清葡萄糖测定及毛细血管全血糖测定2种方法对早产儿进行血糖监测分析，常规治疗对早产儿给予葡萄糖静脉输注，期间使用血糖仪对早产儿采足跟毛细血管全血动态监测血糖，并根据监测结果调整葡萄糖输注的浓度及速度，直至血糖稳定。对检测结果进行回顾性分析，研究糖代谢紊乱的特点及危险因素。结果:118例早产儿中，静脉血糖异常发生率50.8%，静脉低血糖发生率49.2%，静脉高血糖发生率1.69%。低出生体质量和新生儿窒息既是早产儿静脉低血糖的危险因素（P<0.01和P<0.05），也是早产儿末梢高血糖的危险因素（P<0.01）。剖宫产分娩、低出生体质量、双胎和新生儿窒息是早产儿末梢低血糖的独立危险因素（P<0.05～P<0.01）。结论:早产儿糖代谢紊乱发生率高，需要积极监测。采取阴道分娩、积极控制低出生体质量和新生儿窒息是减少早产儿血糖异常的重要措施。

Monitoring and analysis of dysglycemia in preterm infants

Objective: To study the monitoring methods,characteristics and risk factors of dysglycemia in preterm infants.Methods: The level of blood glucose in preterm infants was monitored and analyzed using the venous serum glucose determination and capillary whole blood glucose measurement.All preterm infants were intravenously injected with glucose,the capillary whole blood glucose in heel was dynamically monitored using blood glucose meter,and the concentration and velocity of glucose infusion were adjusted according to the monitoring results until the level of blood glucose was stable.The clinical data of all cases were retrospectively analyzed,and the characteristics and risk factors of dysglycemia were analyzed.Results: Among 118 preterm infants,the abnormal blood glucose rate,incidence rates of dysglycemia,hypoglycemia and hyperglycemia were 50.8%,49.2% and 1.69%,respectively.The low birth weight and asphyxia of newborn in preterm infants were the risk factors of venous hypoglycemia and peripheral blood hyperglycemia(P<0.05 to P<0.01).The cesarean delivery,low birth weight,twin pregnancy and asphyxia of newborn were the independent risk factors in peripheral blood hypoglycemia of preterm infants(P<0.05 to P<0.01).Conclusions: The incidence rate of dysglycemia in preterm infants is high,which should be actively monitored.Positive controlling the low birth weight and asphyxia of newborn is an important measure in reducing the abnormal glucose in preterm infants.