中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
1期
64-66
,共3页
低血糖%婴儿,新生
低血糖%嬰兒,新生
저혈당%영인,신생
Hypoglycemia%Infant,newborn
目的 探讨新生儿低血糖临床干预的阈值.方法 选择我院2007年1月至2009年1月收住的新生儿共128例,分为4组:正常对照组:入院后血浆血糖一直稳定维持在3.30～6.10 mmol/L；观察组Ⅰ组:入院后即刻血浆血糖2.60～3.29 mmol/L,经常规处置后一直在此范围且持续2h,入院4h即稳定维持在正常范围；观察组Ⅱ组:入院后即刻血浆血糖2.20～2.59 mmol/L,经常规处置后一直在此范围且持续2h,入院4h即稳定维持在正常范围；观察组Ⅲ组:入院后即刻血浆血糖＜2.20 mmol/L,经常规处置后一直在此范围且持续2h,入院3h即稳定维持在正常范围.对128例新生儿行闪光视觉诱发电位(flash visual evoked potential,F-VEP)检测,分析主波潜伏期改变.结果 128例新生儿F-VEP主波无一缺失,与正常对照组[ (199.2±14.3)ms]比较,观察组Ⅱ组[(212.9±18.9) ms]和Ⅲ组[(223.1±20.4)ms]主波潜伏期延长,差异有统计学意义(P＜0.01)；观察组Ⅲ组与Ⅱ组比较,主波潜伏期明显延长(P＜0.01)；而观察组I组[(203.3±15.4) ms]主波潜伏期与各组间比较差异无统计学意义(P＞0.05).当观察组Ⅱ组和观察组Ⅲ组新生儿的血浆血糖经治疗稳定维持在3.30 -6.10 mmol/L后,与正常新生儿比较,其主波潜伏期差异无统计学意义[(202.9±15.2) ms,(203.1±15.5) ms vs (199.2±14.3) ms](P＞0.05).结论 无论是否有临床表现,临床医生应当考虑进行临床干预的低血糖水平,即可能引起脑功能障碍的血糖阈值是＜2.60 mmol/L,而非传统的＜2.20 mmol/L,也许是较适宜的.
目的 探討新生兒低血糖臨床榦預的閾值.方法 選擇我院2007年1月至2009年1月收住的新生兒共128例,分為4組:正常對照組:入院後血漿血糖一直穩定維持在3.30～6.10 mmol/L；觀察組Ⅰ組:入院後即刻血漿血糖2.60～3.29 mmol/L,經常規處置後一直在此範圍且持續2h,入院4h即穩定維持在正常範圍；觀察組Ⅱ組:入院後即刻血漿血糖2.20～2.59 mmol/L,經常規處置後一直在此範圍且持續2h,入院4h即穩定維持在正常範圍；觀察組Ⅲ組:入院後即刻血漿血糖＜2.20 mmol/L,經常規處置後一直在此範圍且持續2h,入院3h即穩定維持在正常範圍.對128例新生兒行閃光視覺誘髮電位(flash visual evoked potential,F-VEP)檢測,分析主波潛伏期改變.結果 128例新生兒F-VEP主波無一缺失,與正常對照組[ (199.2±14.3)ms]比較,觀察組Ⅱ組[(212.9±18.9) ms]和Ⅲ組[(223.1±20.4)ms]主波潛伏期延長,差異有統計學意義(P＜0.01)；觀察組Ⅲ組與Ⅱ組比較,主波潛伏期明顯延長(P＜0.01)；而觀察組I組[(203.3±15.4) ms]主波潛伏期與各組間比較差異無統計學意義(P＞0.05).噹觀察組Ⅱ組和觀察組Ⅲ組新生兒的血漿血糖經治療穩定維持在3.30 -6.10 mmol/L後,與正常新生兒比較,其主波潛伏期差異無統計學意義[(202.9±15.2) ms,(203.1±15.5) ms vs (199.2±14.3) ms](P＞0.05).結論 無論是否有臨床錶現,臨床醫生應噹攷慮進行臨床榦預的低血糖水平,即可能引起腦功能障礙的血糖閾值是＜2.60 mmol/L,而非傳統的＜2.20 mmol/L,也許是較適宜的.
목적 탐토신생인저혈당림상간예적역치.방법 선택아원2007년1월지2009년1월수주적신생인공128례,분위4조:정상대조조:입원후혈장혈당일직은정유지재3.30～6.10 mmol/L；관찰조Ⅰ조:입원후즉각혈장혈당2.60～3.29 mmol/L,경상규처치후일직재차범위차지속2h,입원4h즉은정유지재정상범위；관찰조Ⅱ조:입원후즉각혈장혈당2.20～2.59 mmol/L,경상규처치후일직재차범위차지속2h,입원4h즉은정유지재정상범위；관찰조Ⅲ조:입원후즉각혈장혈당＜2.20 mmol/L,경상규처치후일직재차범위차지속2h,입원3h즉은정유지재정상범위.대128례신생인행섬광시각유발전위(flash visual evoked potential,F-VEP)검측,분석주파잠복기개변.결과 128례신생인F-VEP주파무일결실,여정상대조조[ (199.2±14.3)ms]비교,관찰조Ⅱ조[(212.9±18.9) ms]화Ⅲ조[(223.1±20.4)ms]주파잠복기연장,차이유통계학의의(P＜0.01)；관찰조Ⅲ조여Ⅱ조비교,주파잠복기명현연장(P＜0.01)；이관찰조I조[(203.3±15.4) ms]주파잠복기여각조간비교차이무통계학의의(P＞0.05).당관찰조Ⅱ조화관찰조Ⅲ조신생인적혈장혈당경치료은정유지재3.30 -6.10 mmol/L후,여정상신생인비교,기주파잠복기차이무통계학의의[(202.9±15.2) ms,(203.1±15.5) ms vs (199.2±14.3) ms](P＞0.05).결론 무론시부유림상표현,림상의생응당고필진행림상간예적저혈당수평,즉가능인기뇌공능장애적혈당역치시＜2.60 mmol/L,이비전통적＜2.20 mmol/L,야허시교괄의적.
Objective To search clinical operational threshold of neonatal hypoglycemia.Methods From Jan 2007 to Jan 2009,128 neonates in our hospital were divided into 4 groups:normal control group (blood glucose range 3.30 ～ 6.10 mmol/L during hospitalization) ;treatment I group (blood glucose range 2.60 ～ 3.29 mmol/L keep 2 h,maintain normal range after 4 h) ; treatment Ⅱ group ( blood glucose range 2.20 ～ 2.59 mmol/L keep 2 h,maintain normal range after 4 h ) ;treatment Ⅲ group(blood glucose ＜2.20 mmol/L keep 2 h,maintain normal range after 3 h).Relevant data of the latency of main waves on the neonates were collected and analyzed by flash visual evoked potential( F-VEP) test.Results The main waves of F-VEP in all the 128 neonates were existed.The latency of main waves in group Ⅱ [ (212.9 ± 18.9) ms] and group Ⅲ [ (223.1 ±20.4) ms] were significantly longer than that in the normal control group [ ( 199.2 ± 14.3) ms] respectively (P ＜0.01 ),and the latency of main wavesin group Ⅲ were longer than that in group Ⅱ ( P ＜0.01 ).There were no significant difference in group I [ (203.3 ± 15.4) ms ] as compared with the other groups (P ＞ 0.05 ).When blood glucose of the treatment group maintain on 3.30 ～ 6.10 mmol/L,the latency of main waves of F-VEP in group Ⅱ and group Ⅲ [ (202.9 ± 15.2) ms,(203.1 ± 15.5) ms ] had no differences as compared with the control group[ ( 199.2 ± 14.3 ) ms ] (P ＞ 0.05 ).Conclusion It may be appropriate that the threshold of blood glucose for diagnostic criteria of neonatal hypoglycemia is less than 2.60 mmol/L rather than 2.20 mmol/L,whether the neonates have any clinical manifestations or not.
