新生儿窒息糖代谢紊乱的血糖监测及观察

目的探讨新生儿窒息血糖异常的观察经验,判断窒息严重程度及预后,探索有效的观察方法。方法监测我院2008年1月～2010年12月儿科收治的100例确诊为窒息的新生儿,根据Apgar评分分为重度窒息和轻、中、度窒息,用One-Touch 2型微量血糖仪监测生后1、3、12、24、72 h血糖,并进行动态对比观察血糖变化,采取相应的护理措施。结果生后3 h轻、中度窒息患儿血糖异常32例（53.33%）,显著低于重度窒息患儿38例（95.00%）;生后24 h轻、中度窒息患儿血糖异常6例（10.00%）也显著低于重度窒息患儿19例（47.50%）;重度窒息与轻度窒息在血糖异常种类上差异也有高度统计学意义（均P〈0.01）。结论窒息程度越重,血糖异常发生率越高;轻度窒息新生儿血糖异常以低血糖为主,重度窒息以高血糖为主;血糖持续高水平的窒息患儿预后不良。对窒息患儿生后要定期监测血糖,特别是重度窒息患儿应把血糖的变化作为常规判断病情及预后的辅助指标。

Asphyxia glucose metabolism glucose monitoring and observation

Objective To investigate the observed glucose asphyxia experience,determine the severity and prognosis of asphyxia,and explore effective methods of observation.Methods 100 patients admitted to neonatal diagnosis of neonatal asphyxia in our hospital from August 2009 to December 2010 were monitored.Severe asphyxia and mild asphyxia were devided according to Apgar score points,the blood glucose after birth 1,3,12,24,72 h were monitored by One-Touch 2-type micro-monitoring,and blood glucose changes was observed in the dynamic contrast,appropriate care measures were took.Results 3 h after birth,mild to moderate asphyxia glucose rate of 32 cases(53.33%) was significantly lower in children with severe asphyxia in 38 cases(95.00%);24 h after birth,mild to moderate asphyxia glucose 6 cases(10.00%) was significantly lower than children with severe asphyxia in 19 cases(47.50%);asphyxia and mild asphyxia differences in the types of glucose all had highly significantly statistics(all P<0.01).Conclusion The more severe asphyxia,the higher incidence of abnormal glucose;mild asphyxia glucose mainly manifests with low blood sugar,severe asphyxia dominate manifests with high blood sugar;sugar continuing high levels of asphyxia has poor prognosis.After birth asphyxia to be on the regular monitoring of blood glucose,especially changes of blood sugar should be as routine in children with severe asphyxia to determine the condition and prognosis of secondary indicators.