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頁籤選單縮合
題名 | Neurosonographic Findings in High Risk Neonates with Hypoglycemia=高危險群新生兒合併低血糖症之神經超音波學發現 |
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作者姓名(中文) | 沈淵瑤; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 37:4 民85.07-08 |
頁次 | 頁248-252+301 |
分類號 | 417.517 |
關鍵詞 | 神經超音波學; 低血糖症; 新生兒; Neurosonography; Hypoglycemia; Newborn; |
語文 | 英文(English) |
中文摘要 | 葡萄糖是提供中樞社經系統代謝最要的能源,低血糖黨導致意識障礙或神經功能異常。在新生兒加護病房中,低血糖是常見的臨床表徵之一。病人表現出發紺、肌肉張力降低、煩燥不安、意識障礙或痙攣等。嚴重的低血糖可以導致長期功能喪失。本文以前瞻式神經超音波檢查,研究觀察28位符合低血糖定義的新生兒。自入 發現低血糖開始至六個月大,每人各進行總共12次的序列性追踪,綜合其超音波發現及臨床表現,提出研究報告。在第一星期內的超音波圖變化,主要包括:一、散發性迴音昇高(86%)二、腦室受擠壓而縮小(36%)三、腦室週圍迴音增強(28%)四、出血(7%)。一星期後至一個月的異常變化包括:一、腦室週圍迴音增強(22%)二、腦室擴大(7%)三、腦迴影像增加強(18%)。一個月後的異常變化則以週腦室囊狀白質軟化及腦萎縮爲主。具有這些晚期變化的病人,皆合併嚴重的腦神經後遺症。研究顯示具有嚴重腦神經後遺症之病例常合併有新生兒窒息、心臓病、出生體重不足、母親先兆憼厥及母親有糖尿病等合併症,因此上述神經超音波學上發現亦可能與病人之基本病因有關,叭本研究可提示在加護病房發現低血糖之病兒時,進行簡易的腦超音波篩檢。早期的超音波圖變化呆獲救醫師提早進行較積極的治療與處置,以威海病人的傷害。晚期的變化則可能提供預期病人的腦神經後遺症,以早期介入複健。 |
英文摘要 | In a prospective study, 28 neonates with hypoglycemia underwent a series of neurosonographic follow-ups. Most of the patients completed a total of 12 scans beginning on the first day of admission and finishing at age of 6 months. One patient died of intracranial hemorrhage, 5 cases had severe neurological sequelae and 22 cases developed normally. The main sonographic findings during early the neonatal stage included: (1) diffuse increase of echogenecily; (2) compressed ventricles; (3) increased periventricular echogenecily and (4) hemorrhage. In late neonatal stage, the abnormal findings were (1) increased periventricular echogeneciy; (2) ventricular dilatation and (3) increased gyral pattern. Periventricular cystic leukomalacia and brain atrophy were observed on the late follow-up sonography in those cases with neurological sequelae. Hypoglycemia per se’ may not account for all the damage in the brain. Treatment of the underlying causes should start as soon as possible. However, early sonographic finding may provide critical information for vigorous treatment of hypoglycemia, while the late scans enable early prediction of poor neurological outcome. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。