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目的探讨围产期窒息对新生儿血糖的影响因素以及病程中血糖变化,为治疗及监护提供依据。方法对38例窒息新生儿生后72 h进行连续血糖监测,其中静脉输糖14例,复苏用药18例,未用药6例。结果微量血糖平均值随日龄增加呈不断递升现象(经方差分析,F=10.46,P<0.01);生后24 h剖宫产组血糖水平低于正常分娩组(P<0.01);生后12、24h窒息组血糖水平低于对照组,且低血糖发生率高于对照组(P<0.01);生后48、72 h两组血糖水平差异无统计学意义(P>0.05);窒息组血糖异常发生率高于对照组(χ2=12.74,P<0.01)。结论窒息复苏后新生儿血糖异常发生率明显高于正常新生儿;血糖平均值处于较低水平,且低血糖发生率高于正常新生儿;窒息复苏过程中输糖或用药,会对机体糖代谢产生影响,应慎重应用;血糖动态监测对窒息新生儿尤为重要,窒息复苏及后续治疗中均应重视血糖监测及调整。
Objective To investigate the influencing factors of perinatal asphyxia on neonatal blood glucose and the changes of blood glucose in the course of disease, so as to provide basis for treatment and monitoring. Methods Thirty-eight neonates with asphyxia were monitored for blood glucose 72 hrs after birth, including 14 cases of intravenous glucose, 18 cases of resuscitation and 6 cases of no medication. Results The average value of micro-blood glucose showed an increasing trend with the increase of the age (F = 10.46, P <0.01 by ANOVA). The blood glucose of the cesarean section group was lower than that of the normal delivery group 24 h after birth (P <0.01) The level of blood glucose in the asphyxia group was lower than that in the control group on 12 and 24 hours, and the incidence of hypoglycemia was higher than that in the control group (P <0.01). There was no significant difference in blood glucose level between the two groups at 48 and 72 hours after birth (P> 0.05) The incidence of abnormal blood glucose was higher than that of the control group (χ2 = 12.74, P <0.01). Conclusion The incidence of neonatal hypoglycemia after asphyxia resuscitation is significantly higher than that of normal newborns. The mean of blood glucose is at a low level and the incidence of hypoglycemia is higher than that of normal neonates. In the process of asphyxia resuscitation, Have an impact, should be carefully applied; dynamic monitoring of blood glucose is particularly important for neonatal asphyxia, apnea recovery and follow-up treatment should pay attention to blood glucose monitoring and adjustment.