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題名 | Spontaneous Diuresis in Premature Infants with Hyaline Membrane Disease=肺玻璃病變早產兒的自然利尿 |
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作者姓名(中文) | 楊宏義; 林其和; 陳森輝; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 28:5 民76.09-10 |
頁次 | 頁278-287 |
分類號 | 417.5171 |
關鍵詞 | 早產兒; 自然; 利尿; 肺; 玻璃; 病變; |
語文 | 英文(English) |
中文摘要 | 爲了研究肺玻璃病變早產兒的自然利尿,將46例早產兒分成三羣,第一羣為體重>1,500公克的肺玻璃病兒,第二羣為體重≤1,500公克的肺玻璃病兒,第三羣為體重≤1,500公克且無肺玻璃病的早產兒;第一羣和第二羣比較是為了研究出生體重對自然利尿的影響,而第二羣和第三羣比較則為了研究肺玻璃病本身對自然利尿的影響。所有早產兒在出生後30到36小時發生自然利尿。第一羣比第二羣有較多的病例經由剖腹產出生、較長的利尿期、和生後第5天較少的體重減輕;第二羣比第三羣有較長的利尿期和生後第5天較多的體重減輕。第一羣及第二羣的吸入氧濃度、肺泡一動脈氧分壓差、及平均氣道壓大約在利尿開始後56至72小時間出現統計學上有意義的進步。第一羣在利尿出現16小時內動脈氧分壓時常超過100釐米汞柱,但第二羣則無此現象。本文發現體重>1,500公克的肺玻璃病兒有較長的利尿期,可能表示體內有較多的水份,使用furosemide 可能促進這些病兒的恢復。由於肺功能在利尿後逐漸改善,如果在利尿期發生之前便以其他方法增加非知覺性水份的喪失,也許可以加速肺玻璃病兒的恢復。 |
英文摘要 | To study spontaneous diuresis in premature infants with hyaline membrane disease (HMD), a total of 46 cases was classified into three groups: Group 1, infants with HMD, weighing>1,500 grams; Group 2, infants with HMD, weighing ≤1,500 grams; and Group 3, infants without HMD, weighing ≤1,500 grams. Comparisons of Group 1 with Group 2 and Group 2 with Group 3 were made to assess the influence of birth weight and of HMD itself on spontaneous diuresis. All the premature infants with or without HMD had an onset of spontaneous diuresis at about 30 to 36 hours of postnatal age. Group 1, with more cases delivered by Caesarean section, had longer duration of diuresis and less body weight loss at Day five than Group 2, whereas Group 2 had diuresis of longer duration and more weight loss at Day five than Group 3. Significant improvement in inspired fraction of oxygen concentration (FiO2), alveolar-arterial oxygen difference (A-aDO2), and mean airway pressure (MAP) occured at 56 to 72 hours after the onset of diuresis in Groups 1 and 2. Sudden elevation of arterial oxygen tension (PaO2) to above 100 mmHg within 16 hours after onset of diuresis occurred frequently in Group 1, but not in Group 2. This study demonstrated that infants with HMD weighing>1,500 grams had a longer duration of diuresis, which could be a reflection of more body water content. Administration of furosemide could possibly facilitate the recovery of these patients. Since pulmonary function improved gradually following diuresis, the enhancement of insensible water loss in anticipation of the onset of diuresis is speculated to be a potentially effective method for accelerating recovery of infants with HMD. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。