摘要
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3．30～6．10mmol／L；观察组I组：入院后即刻血浆血糖2．60～3．29mmol／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2．20～2．59mmol／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〈2．20mmol／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—6．10mmol/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）msVS（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〈2．60mmol／L，而非传统的〈2．20mmol／L，也许是较适宜的。
Objective To search clinical operational threshold of neonatal hypoglycemia. Methods Fro,m Jan 2007 to Jail 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 1I group （ blood glucose range 2. 20 - 2. 59 mmol/L keep 2 h,maintain normal range after 4 h ） ;treatment Ill group（blood glucose 〈 2. 20 mmol/L keep 2 h,malntain norrnal 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 we：re 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 waves in group III were longer than that in group 11 （ 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 11 and group 11I [ （202.9 ± 15.2） ms, （203. 1 ± 15. 5） ms] had no differ- ences as compared with the control group[ （ 199.2 ± 14. 3） ms] （P 〉 0. 05）. Conclusion It may be appro- priate 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.
出处
《中国小儿急救医学》
CAS
2012年第1期64-66,共3页
Chinese Pediatric Emergency Medicine
关键词
低血糖
婴儿
新生
Hypoglycemia
Infant, newborn
