新生儿围手术期血液内环境变化及意义——附40例临床分析

Changes of serum biochemical parameters in newborns during perioperation: A clinical study of 40 cases

摘要:

目的：新生儿外科疾病以消化道畸形最常见(占40% ),常需生后即行手术治疗,围术期的血液内环境变化有其特点,故监测分析新生儿围术期血液内环境变化有重要的临床意义。方法：对40例新生儿外科手术前后的血常规、电解质及血糖进行分析。结果：手术后患儿的血白细胞计数无明显改变,但白细胞分类中淋巴细胞比例比术前明显增高, 0. 40±0. 17vs0. 34±0. 15,差异有显著性, (P<0. 05)。血红蛋白明显降低130. 89±27. 17g/Lvs142. 11±33. 09g/L(P<0. 05)。血清Na+、K+、Ca2+等离子无明显改变,但血糖在手术后比手术前明显增高10. 20±6. 89mmol/Lvs6. 90±6. 24mmol/L(P<0. 05)。结论：新生儿外科围术期应加强监护,注意贫血、高血糖及出血的发生。

Abstract:

OBJECTIVE: Digestive tract malformation is most common in neonatal surgical diseases, for which early surgery is required. The purpose of this study was to show the importance of perioperative biochemical monitoring in newborns. METHODS: Forty neonates with surgical diseases (digestive tract malformation accounting for 40%) aged 13.8±12.7 days were included in this study. Serum biochemical parameters, including blood routine, electrolytes and blood sugar were determined before and after operation. RESULTS: The white blood cell count was within normal range but the ratio of lymphocyte in the differential count significantly increased from 0.34±0.15 to 0.40±0.17 after operation ( P < 0.05 ). In contrast, the hemoglobin level decreased significantly after operation (from 142.11±33.09 g/L to 130.89±27.17 g/L, P < 0.05 ). The levels of serum Na+, K+ and Ca 2+ were not significantly different, while blood sugar contents increased significantly from 6.90±6.24 mmol/L to 10.20±6.89 mmol/L post-operatively (P < 0.05 ). CONCLUSIONS: Post-operatively, neonates may be prone to developing anemia and hyperglycemia. It is important to monitor the changes of biochemical parameters during perioperation.