182例新生儿缺氧缺血性脑病电解质变化临床探究.doc

182例新生儿缺氧缺血性脑病电解质变化临床探究[摘要] 目的 探讨新生儿缺氧缺血性脑病（hypoxic ischemic encephalopathy，HIE）的血清电解质变化及其临床意义。方法 选择2009年2月～2011年3月我科收治的HIE患儿182例为研究对象，为HIE组，180例正常新生儿为对照组，测定两组患儿的电解质。 结果 HIE组患儿平均血糖明显高于对照组，血钙、血氯、血钠明显低于对照组；不同程度HIE组之间血钙、血氯、血钠值差异有统计学意义（P＜0.05）。结论 HIE患儿易发生电解质紊乱，并且与病情程度具有明显相关性。HIE患儿血清电解质紊乱较常见，血清Na+、Cl-、Ca2+测定有助于分析病情及评价病情严重程度。检测电解质的变化对缺血缺氧性脑病的治疗和预后有重要价值。 [关键词] 新生儿；缺氧缺血性脑病；电解质 [中图分类号] R722.12[文献标识码] B[文章编号] 1673-9701（2011）20-37-02 Clinical Research of Blood Electrolyte Levels in 182 Neonates with Hypoxic Ischemic Encephalopathy WANG Xiaohu Department of Neonatology，the Third Peoples Hospital of Zibo City，Shandong Province，Zibo 255000，China [Abstract] Objective To explore the values of blood electrolyte levels in neonates with hypoxic ischemic encephalopathy（HIE）and its clinical significance.Methods One hundred eighty-two neonates with HIE and 180 normal neonates（control group）who were admitted into our department from Feb 2009 to Mar 2011 were selected and their blood electrolyte levels were detected. Results The average blood calcium，chlorine，and sodium levels were significantly lower in HIE neonates than those in control group. There was a significant difference in the average blood calcium，chlorine，and sodium levels among the HIE subgroups of various severities. The difference was significant in the frequency of the abnormal blood electrolyte disorder among the groups with different severity of the disease. Conclusion The HIE neonates often has abnormal blood electrolyte disorder. The disorder degree of blood electrolyte levels is closely related with the severity of the disease. Detection of blood electrolyte is important for the treatment and prediction of prognosis of HIE. [Key words] Neonates；HIE；Electrolytes 新生儿HIE是由于窒息引起的严重并发症，严重者可造成永久性神经功能障碍以及不可逆性脑损伤。HIE时，因窒息和进食减少的影响，更易发生内环境紊乱，而内环境紊乱将进一步损伤心、脑、肾等重要脏器。故处理及时，对HIE的预后十分有利。本文对2009年2月～2011年3月我科NICU 182例HIE新生儿进行血清电解质（K+、Ca2+、Na+、Cl-）测定并计算阴离子间隙（anion gaps，AG），对比分析同期住院180例非窒息婴儿的血清电解质，研究HIE严重程度与其电解质变化