CAJ | 학술논문

目的：探讨新生儿低血糖性脑损伤的临床表现和影像学特征。方法回顾性分析2011年7月-2013年6月住院治疗的低血糖新生儿62例临床资料，根据低血糖脑损伤诊断标准分为脑损伤组30例和无脑损伤组32例，比较2组首诊时间、喂奶时间及血糖等情况。结果2组在出生体质量、胎龄、首次诊断低血糖时间等方面比较差异无统计学意义（ P ＞0湝．05）；脑损伤组平均最低血糖值低于无脑损伤组[（1．3±0．4） mmol/L vs．（1．6±0．3） mmol/L， t ＝3．507， P ＜0．01]，低血糖持续时间长于无脑损伤组[（28．4±11．2） h vs．（6．0±2．5） h， t ＝10．711， P ＜0．01]，喂奶时间迟于无脑损伤组[（1．8±0．4）h vs．（0．8±0．2）h， t ＝12．445， P ＜0．01]。新生儿低血糖性脑损伤的临床表现以惊厥、拒乳、反应差最常见。颅脑MR或CT影像学特征以枕顶部受累最常见。随访6个月，脑损伤组留有神经系统后遗症9例，无脑损伤组无1例发生。结论对存在高危因素的新生儿，应及早监测血糖，及时干预，以预防低血糖性脑损伤的发生。颅脑MR或CT示枕顶部受累，有利于低血糖性脑损伤的诊断。
목적：탐토신생인저혈당성뇌손상적림상표현화영상학특정。방법회고성분석2011년7월-2013년6월주원치료적저혈당신생인62례림상자료，근거저혈당뇌손상진단표준분위뇌손상조30례화무뇌손상조32례，비교2조수진시간、위내시간급혈당등정황。결과2조재출생체질량、태령、수차진단저혈당시간등방면비교차이무통계학의의（ P ＞0개．05）；뇌손상조평균최저혈당치저우무뇌손상조[（1．3±0．4） mmol/L vs．（1．6±0．3） mmol/L， t ＝3．507， P ＜0．01]，저혈당지속시간장우무뇌손상조[（28．4±11．2） h vs．（6．0±2．5） h， t ＝10．711， P ＜0．01]，위내시간지우무뇌손상조[（1．8±0．4）h vs．（0．8±0．2）h， t ＝12．445， P ＜0．01]。신생인저혈당성뇌손상적림상표현이량궐、거유、반응차최상견。로뇌MR혹CT영상학특정이침정부수루최상견。수방6개월，뇌손상조류유신경계통후유증9례，무뇌손상조무1례발생。결론대존재고위인소적신생인，응급조감측혈당，급시간예，이예방저혈당성뇌손상적발생。로뇌MR혹CT시침정부수루，유리우저혈당성뇌손상적진단。
Objective To investigate the clinical manifestations and imaging characteristics of neonatal hypoglycemic brain injury.Methods From July 2011 to June 2013, retrospectively analyzed clinical data of 62 cases of hospitalized neo-natal hypoglycemia , according to brain injury , they were divided into brain injury group of 30 cases and non-brain injury group of 32 cases, compared the 2 groups’ first treatment time, open milk time and blood glucose etc .Results The difference of the 2 groups’ birth weight, gestational age, the first diagnosis of hypoglycemia time revealed no significant ( P >0.05);brain injury group’s minimum average blood glucose value lower than that without brain injury group [(1.3 ±0.4) mmol/L vs.(1.6 ±0.3) mmol/L, t =3.507, P <0.01], hypoglycemia lasts longer than without brain injury group [(28.4 ±11.2) h vs.(6.0 ±2.5) h, t =10.711, P <0.01], delayed feeding time longer than without brain injury group [(1.8 ±0.4) h vs.(0.8 ±0.2) h, t =12.445, P <0.01].The most common clinical manifestations of neonatal hypoglycemic brain injury were convulsion , milk refusal and the indifference response .Brain MR or CT brain image characteristics revealed that the most common involvement areas are occipital and parietal lobe .Follow up was 6 months, brain injury group have sequela of nervous system in 9 cases, and no case in non-brain injury group.Conclusion For neonates with high risk factors , early blood glu-cose monitoring , timely intervention is necessary to prevent the occurrence of hypoglycemic brain injury .Cranial MR and brain CT revealed the occipital and parietal lobe involvement is helpful for diagnosis of hypoglycemic brain injury .