低胎龄早产儿生后2周内补充钙、磷对肾功能电解质、尿检的影响

发布时间：2019-06-28 11:56

【摘要】：目的:观察低胎龄早产儿生后2周内补充钙、磷后肾功能电解质及尿检验指标变化及其临床意义。方法:2013年1月-2015年8月在本院新生儿科住院的33周的早产儿共102例,其中35例为胎龄28~30周,67例为胎龄30~32周。按入院先后顺序分成4组:对照组、单纯补钙组、单纯补磷组、钙磷同补组,除对照组外,余三组均在生后第2天开始按以上分组补充钙磷至生后14d。分别于出生7、14d抽血检测肾功能、血清钙、磷水平;留尿检测尿常规、尿钙水平,有镜下血尿者查尿肌酐。结果:(1)对照组:生后第2周未补充钙磷,部分出现低磷血症,以28~30周胎龄儿尤为明显,肾功能均正常。(2)单纯补钙组:部分早产儿出现镜下血尿,尿钙/肌酐比值提示高钙尿症,血肌酐轻度升高提示肾功能损害,且以28~30周胎龄儿尤为明显,但血钙磷并无异常。(3)单纯补磷组:部分早产儿出现低钙血症,以28~30周胎龄儿尤为明显,肾功能均正常。(4)钙磷同补组:合适比例的钙磷同补,能维持血钙磷平衡、肾功能正常、尿检正常。结论:生后第2周未补充钙磷,可能出现低磷血症;单纯补钙可能导致高钙尿症及肾功能损害;单纯补磷,易出现低钙;以上情况均以28~30周胎龄儿尤为明显。而合适比例的钙磷同补能促血钙磷平衡,避免肾功能损害。
[Abstract]:Objective: to observe the changes and clinical significance of renal function electrolytes and urine after calcium supplementation and phosphorus supplementation in low gestational age premature infants within 2 weeks after birth. Methods: from January 2013 to August 2015, 102 premature infants were hospitalized in neonatal pediatrics from January 2013 to August 2015, including 35 premature infants with gestational age of 28 weeks and 67 cases with gestational age of 30 weeks and 32 weeks. According to the order of admission, they were divided into four groups: control group, simple calcium supplementation group, simple phosphorus supplementation group, calcium and phosphorus supplementation group, except the control group, the other three groups began to supplement calcium and phosphorus according to the above groups on the 2nd day after birth until 14 days after birth. Renal function, serum calcium and phosphorus levels were measured on the 7th and 14th day after birth, urine routine and urinary calcium levels were measured, and urine creatinine was measured in patients with microscopic hematuria. Results: (1) in the control group, there was no calcium and phosphorus supplementation at the 2nd week after birth, and some of them had hypophosphatemia, especially in 28 鈮，

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