目的：探讨足月窒息新生儿血糖监测的临床意义。方法回顾性分析2011年1月至2012年12月收治的足月窒息新生儿在入院24 h内检测的血糖水平及其与预后的关系。结果256例足月窒息新生儿中，血糖异常95例（37.11%），其中低血糖63例（24.61%），高血糖32例（12.50%）；血糖正常161例（62.89%）。低血糖、正常血糖和高血糖三组新生儿，轻度和重度窒息的分布及不同功能损害所累及器官数目的差异有统计学意义（P均<0.001）；三组中足月小样儿、正常出生体质量儿以及巨大儿分布的差异无统计学意义（P=0.094）。256例患儿中，206例轻度窒息，50例重度窒息，重度窒息患儿血糖异常以及高血糖的比例均高于轻度窒息，差异有统计学意义（P均<0.001）；227例（88.67%）累及器官发生功能损害，96例累及1个器官，72例累及2个，59例累及≥3个，三组间血糖异常、低血糖以及高血糖比例差异有统计学意义（P均<0.05）；累及≥3个器官患儿的血糖异常和高血糖比例较高，而累及2个器官患儿低血糖的发生比例较高。结论重度窒息、功能损害所累及器官数多的足月窒息儿更易发生高血糖。%Objective To investigate the clinical significance of monitoring blood glucose in term infants with asphyxia. Methods The blood glucouse within 24 hours of admission and prognosis were retrospectively analyzed in full-term neonates with asphyxia admitted from January, 2011 to December, 2012. Results Among 256 term infants with asphyxia, 95 cases (37.11%) had abnormal blood glucose, 63 cases (24.61%) were hypoglycemia and 32 (12.50%) were hyperglycemia. The incidence of mild asphyxia and severe asphyxia, the number of damaged organ were significantly different among infants with hypoglycemia, normal blood glucose, and hyperglycemia (all P<0.001). Among 256 term infants, 206 cases were mild asphyxia, 50 cases were serve asphyxia. The incidence of abnormal blood glucose and hyperglycemia were significantly higher in infants with serve asphyxia than those in infants with mild asphyxia (P<0.01). Among 256 term infants, 227 cases (88.67%) had organ damaged. 96 cases involved one organ, 72 cases involved two organs, and 59 cases involved three or more organs. The incidence of abnormal blood glucose, hypoglycemia, hyperglucemia were significantly different among infants invoved one, two or threr and more organs. The incidence of hyperglycemia was the highest in infants with three or more organ damaged, and the incidence of hypoglycemia was the highest in infants with two organ damaged. Conclusions The term infants with severe asphyxia and more organ damaged were prone to with abnormal blood glucose.
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