论文部分内容阅读
目的 探讨小于胎龄儿 (small for gestational age infant,SGA儿 )血糖监测的重点对象及持续时间 ,减少血糖异常造成的损伤。 方法 对 37例出生 (2 .6± 2 .4) h (0 .2 5～ 10 .0 h,中位数 2 .0 h)、非 NICU收治、入院时无输液且未开始喂养的 SGA儿进行为时 (133± 115 ) h (16～ 5 2 4h,中位数 93h)的血糖监测。 结果 监测过程中 2 4例 (6 4% )出现血糖异常 ,其中低血糖 19例(5 1% ) ,高血糖 2例 (5 % ) ,高血糖及低血糖均有发生 3例 (8% )。血糖异常最后发生时间的中位数为10 h,其 95 %可信限为 5～ 5 5 h。 3例反复低血糖发生时间超过 2 40 h。逐步回归分析显示分娩方式与早期血糖水平有关 (P=0 .0 13) ,自然分娩者早期血糖水平高 ;出生体重越低 ,血糖异常最后发生时间越晚 (P<0 .0 1)。另外 ,分析结果显示男婴血糖异常最后发生时间较晚 (P=0 .0 8)。监测期间 ,所有SGA儿未出现血糖异常的相应症状 ,13例予以部分或全静脉营养。 结论 SGA儿为血糖异常 ,特别是低血糖高危人群 ;对非自然分娩出生的 SGA儿 ,尤应注意早期血糖监测 ;对所有 SGA儿 ,尤其是出生体重及其百分位数低者、男婴应行动态血糖监测 ,并持续至出生后 5 5 h
Objective To investigate the key target and duration of blood glucose monitoring in small for gestational age infant (SGA) and to reduce the damage caused by abnormal blood glucose. Methods Thirty-seven SGA children born at (2.2 ± 2. 4) h (0.52-10.0 h, median 2.0 h) were enrolled in the study. Blood glucose was monitored as (133 ± 115) h (16-542 h, median 93 h). Results 24 cases (6.4%) had abnormal blood glucose during the monitoring period, including 19 cases of hypoglycemia (5 1%), 2 cases of hyperglycemia (5%), 3 cases of hyperglycemia and hypoglycemia (8%), . The median time to the last blood glucose abnormality was 10 h, with a 95% confidence limit of 5 to 55 h. 3 cases of repeated hypoglycemia occurred more than 240 h. Stepwise regression analysis showed that the mode of delivery was associated with early blood glucose levels (P = 0.013), with high levels of early blood glucose in the spontaneous delivery, lower birth weights, and later events in which glucose abnormalities occurred later (P <0.01). In addition, the results of the analysis showed that late onset of blood glucose abnormalities in male babies was late (P = 0.08). During the monitoring, all SGA children did not appear the corresponding symptoms of abnormal blood glucose, 13 cases of partial or total parenteral nutrition. Conclusion SGA children with abnormal blood glucose, especially those at high risk of hypoglycemia; SGA children born in unnatural births should pay special attention to early blood glucose monitoring; for all SGA children, especially those with low birth weight and its low percentile, Should be dynamic blood glucose monitoring, and continued until 5h after birth