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題 名 | Breastfeeding-associated Neonatal Hypernatremic Dehydration in a Medical Center: A Clinical Investigation=醫學中心母乳哺育新生兒高血鈉脫水症:臨床分析 |
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作 者 | 王安慶; 陳錫洲; 喻永生; 華一鳴; 盧章智; 李春銘; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷 期 | 48:4 2007.07-08[民96.07-08] |
頁 次 | 頁186-190+234 |
分類號 | 417.517 |
關鍵詞 | 高血鈉; 脫水; 母乳哺育; 新生兒; Hypernatremia; Dehydration; Breastfeeding; Neonate; |
語 文 | 英文(English) |
中文摘要 | 背景:隨著母乳哺育的比率增加後,哺育性新生兒高血鈉脫水症為其中可能造成之嚴重併發症,特別是純餵母乳。方法:針對此主題,北部某醫學中心,藉由回溯性分析2002年一月份至2005年12月份四年間,超過36週,體重大於2000gm,且出生年紀小於28天之新生兒,因純餵母乳造成哺育性高血鈉脫水症而住院之案例。試分析其流行病學上臨床特徵和可能之因素。結果:共有9位新生兒因高血鈉脫水症而住院。發生率為0.23%。臨床上發生時間為3至14天不等,其中5位在出生一週內出現病徵。喪失體重為12%至29%,平均血鈉為153mEq/L,其中有5位哺育之母乳有較高鈉成份。最常見之病徵為黃疸。四位新生兒因較嚴重之脫水而接受額外靜脈輸液。住院中9位新生兒均接受母乳及配方奶混合哺育,全部病例後續追蹤均無復發或併發後遺症。結論:針對此潛在被忽略之問題,建議所有產婦均須被教導母乳哺育之技巧,特別是針對初產婦,需觀查母乳哺育是否適當,以及是否新生兒脫水。並且建議新生兒出生後均需接受追蹤及體重評估以減少可能出現之嚴重後遺症。 |
英文摘要 | Background: Hypernatremic dehydration amongst exclusively breastfed neonates due to inadequate breastfeeding or underfeeding is a potentially devastating condition. We investigated the epidemiological and clinic features of hypernatremic dehydration. Methods: We retrospectively reviewed the medical records of neonates that were less than 28 days of age, weighing ≥2,000 g with gestational age of 36 weeks born between January 2002 and December 2005, who had meet the criteria of hypernatremic dehydration, including 1) exclusively breastfed; 2) loss of weight 12% or more from birth weight; and 3) serum sodium concentration of at least 150 mmol/L at presentation, that had been subsequently admitted to our institution. Results: Totally nine cases were found during this four-year period, an incidence of 2.3 per 1000 live births. Involved infants' age at presentation ranged from 3 days to 14 days (mean±Standard Deviation =7±[3.8]); five presented symptoms or signs within the first week of life. Study-involved infants featured a birth-weight loss ranging from 12% to 29% (mean±[SD]=17.0±[5.9]), and also hypernatremia (mean±[SD]=153.5±[3.2] mEq/L ). Sodium concentration of breast milk ranged from 15 mEq/L to 54 mEq/L (mean±[SD]=36.0±[14.32]). Subsequently, all were supplemented with breast milk or, alternatively, formula. None of the study-involved neonates suffered subsequent complications or a relapse of their condition. Conclusions: Neonatal hypernatremic dehydration due to inadequate breastfeeding or underfeeding would appear to be a rather common problem. In order to avoid serious morbidity and mortality, all breastfed infants should receive regular follow-up by health-care worker. Furthermore, we advocate that all mothers should be taught the skills of breastfeeding, and warning signs of breastfeeding failure and hypernatremia, accompanied with the monitoring of the weight of infants until growth commences, in order to reduce the likelihood of this condition arising, especially for first-time mothers. |
本系統中英文摘要資訊取自各篇刊載內容。