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相關文獻
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頁籤選單縮合
題 名 | Hyperkalemia during the Early Postnatal Days in Premature Infants=早產兒早期高血鉀症之觀察 |
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作 者 | 袁瀚之; 鄭玫枝; 宋文舉; 陳淑貞; 黃碧桃; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷 期 | 44:4 民92.07-08 |
頁 次 | 頁208-214+257 |
分類號 | 417.5171 |
關鍵詞 | 早產兒; 高血鉀; Prematurity; Hyperkalemia; |
語 文 | 英文(English) |
中文摘要 | 電解質不平衡在極度早産兒是一個常見的問題,主因包括水分經皮膚大量揮發而流失以及腎臓代償功能不良所致。其中高四症可引起許多嚴重的症狀,甚至死亡。本研究計盡回溯性地分析95位在新生兒加護病房隹院之重症新生兒病況。病嬰出生後四日內的體重、進食量、每日液體攝取量、排尿量、血清中的鈉離子、鉀離子、BUN、Creatinine以及臨床相關頭況等都記錄並比較分析。我們發現血清中的鉀離子與懷孕週數及出生體重有明顯的負相關性。懷孕週數小於29週的病嬰與其他組別相比,其血鉀濃度最高而且最高點出現在第24至48小時,同時其無感性水分流失量也較高。個案中42人血鉀濃度超過6.0mEq/L,其於53人血鉀濃度均低於6.0mEq/L。經詳細分析後發現高血鉀組女性較多、RDS嚴重度較高、較常使用表面張力素與昇壓劑、四天內開始餵食者較少以及存活率較低(P<0.05)。結論是,高血鉀症囫發生在極度早産兒出生後的前兩天。這些發生高血鉀症之早産兒懷孕週數較少、出生體重較輕、女性較多、RDS嚴重度較高、較常使用表面張力素與昇壓劑、較晚開始餵食,且存活率較低。因此在臨床照顧上必須小心地監測鉀離子濃度並且積極地治療高血鉀症。 |
英文摘要 | Plasma electrolyte concentrations in premature infants are unstable, and hyperkalemia may induce significant, even life-threatening, symptoms in tiny infants. The medical records of 95 premature infants were retrospectively reviewed. Patients with a major congenital anomaly or mortality within 24 h after birth were excluded. Plasma electrolytes, blood urea nitrogen, creatinine, blood pH, urine output, and related clinical conditions during first 96 h of flfe were analyzed. Plasma potassium concentrations had significant negative correlations with gestational age and birth weight (p<0.05). Infants with a gestational age of less than 29 weeks had significantly higher potassium concentrations (average 5.9±0.3mEq/L, peak 7.8±0.4mEq/L, p<0.05) than other gestational age groups, and their plasma potassium levels were significantly higher at 24 and 48h of age (p<0.05). Forty-two infants (42/95, 44%) had peak plasma potassium concentrations greater than or equal to 6mEq/L. With statistical analysis, the hyperkalemic infants comprised of significantly (p<0.05) fewer males (31% vs. 55%), they had more-severe respiratory distress syndrome (RDS) (grades 2±0 vs. 1±0, p<0.05), and needed more frequent use of inotropics (52% vs. 23%, p<0.05) compared to normokalemic infants. In conclusion, hyperkalemia during the first 2 days of life is common in extremely premature infants. Small gestational age, very low birth weight, female gender, high RDS grade, need of exogenous surfactant and inotropic agents, delayed feeding, and a high mortality rate were observed in hyperkalemic infants. |
本系統中英文摘要資訊取自各篇刊載內容。