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目的:探讨窒息后高胆红素血症新生儿的阴离子间隙(anion gap,AG)变化,为治疗提供依据。方法:测定62例窒息后高胆红素血症新生儿的血电解质、肾功能、肝功能,计算AG值,46例同时做动脉血气分析。结果:高AG 28例(45.16%)、正常AG 32例(51.61%)、低AG 2例(3.23%)。AG增高与血Na+浓度成正比,与HCO3-呈反比,与血Cl-和BUN、Scr无明显相关性。轻、重度窒息后高胆红素血症新生儿的AG水平、高AG发生率、血电解质及肾功能比较均无显著性差异。结论:窒息后高胆红素血症新生儿高AG代酸发生率高,应常规测定血电解质及动脉血气分析,计算AG值指导治疗,以免盲目用碱纠酸。
Objective: To investigate the change of anion gap (AG) in neonates with hyperbilirubinemia after asphyxia, and to provide basis for treatment. Methods: The blood electrolytes, renal function and liver function were measured in 62 neonates with hyperbilirubinemia after asphyxia. The AG value was calculated and 46 cases were also analyzed by arterial blood gas analysis. Results: There were 28 cases with high AG (45.16%), 32 cases with normal AG (51.61%) and 2 cases (3.23%) with low AG. AG increased with the blood Na + concentration is proportional to, and inversely proportional to HCO3-, and blood Cl- and BUN, Scr no significant correlation. There was no significant difference in AG level, incidence of high AG, blood electrolyte and renal function between neonates with mild and severe asphyxia after hyperbilirubinemia. Conclusion: Asphyxia hyperbilirubinaemia neonates with high incidence of AG acid, blood electrolytes and arterial blood gas analysis should be routinely measured, calculated AG value of the guide treatment, so as not to use blind alkali correction acid.