新生儿胃肌电变化的研究

目的观察新生儿胃肌电发育过程,并初步探讨其变化规律.方法对23例健康新生儿生后1周、2周及1月进行胃肌电描记.采用皮肤表面电极,从腹壁体表用PCPOLYGRAP-HR多功能胃肠检测仪记录胃电,观察主频率(DF)、主频率不稳定系数(DFIC)、正常胃慢波百分比(PNSW).结果餐前、餐后正常呈随周龄增大而增加的趋势,餐后PNSW明显高于餐前.DF和DFIC各阶段无明显差异,但自身比较,餐后DF高于餐前,餐后DFIC低于餐前.结论研究显示出新生儿胃电肌运动的发育过程.     

新生儿缺氧缺血性脑病患儿胃电活动的监测

目的探讨HIE患儿胃电活动的变化 ,我们对50例HIE患儿和20例正常新生儿胃电图进行了动态观察和分析。方法根据B超结果将胃电图 (EGG)记录仪电极放置在胃窦和胃体部的腹壁上投影位置 ,参考电极放置在下腹部外侧 ,记录时间为10～18h ,检测结束后将EGG记录仪接到计算机上 ,通过Synectics公司的EGGVersion6.40软件分析系统 ,采用运行频谱分析法对采集的EGG信号进行数据处理。分析胃电图主频 (DF)、主功频率不稳定系数 (DFIC)、喂奶后/喂奶前主功率比值 (PR)、正常慢波节律百分比和胃电节律紊乱百分比的变化。结果HIE组32例 (轻度组8例 ,中度组11例 ,重度组13例 ) ,对照组12例 ,成功记录到EGG。HIE轻度组与对照组比较 ,喂奶前后胃电活动无明显变化 ;中、重度组与对照组比较 ,喂奶前胃动过缓明显增多 (P<0.01) ,喂奶后胃电节律更加紊乱 ,正常慢波百分比明显降低 ,胃动过缓和胃动过速均明显增多 (P<0.01)。重度HIE组喂奶前后、中度组喂奶后DF不在正常慢波范围内 ,其余各组DF均在正常慢波范围内 ;与对照组比较 ,HIE组喂奶前后DFIC与PR的变化均无显著意义。结论轻度HIE对新生儿胃电活动无明显影响 ,中、重度HIE能造成新生儿胃电活动异常 ,出现胃电节律紊乱 ,开始肠道喂养时要注意其对胃电活动的影响 ,必要时可酌情     

40例6～14岁正常儿童胃电参数研究

胃电图是应用腹部体表电极记录胃肌电活动的一种技术,是判断胃运动功能的良好指标。我国开展胃电图研究已有多年,成人胃电参数的研究已取得成效,儿童研究却较少,目前我国尚无儿童多导胃电图参数研究的报道。既往研究认为,4岁以上儿童的胃电参数基本接近成人,临床研究也多以成人参数做为参考数值。我们于2003年3月至11月采用瑞典Synectics公司生产的Polygraf ID多道胃电图记录分析系统对40例正常儿童进行胃电图参数的研究,以发现正常儿童的胃电图参数。     

小儿胃电节律失常68例

我们自1991年10月在取得60例健康儿童胃电图各项正常参数的基础上，至1997年10月已对292例各类胃病患儿进行了胃电图记录，其中68例表现胃电节律失常，现就胃电节律失常患儿的临床资料分析如下。临床资料一、一般情况：本文共68例，其中男42例，女26例，年龄3～14a，～6a22例，     

窒息新生儿胃电节律改变及普瑞博思的疗效观察

目的探讨窒息对新生儿胃电活动的影响及普瑞博思的疗效。方法利用体表胃电图(EGG)对50例窒息新生儿和20例正常新生儿哺乳前后进行30min至1h的胃电活动监测。对胃肠症状明显的7例窒息儿使用普瑞博思乳剂治疗7天,治疗前后监测EGG。结果70例新生儿有39例(56％)成功记录到EGG。轻度窒息组较对照组哺乳前胃动过缓[＜2周/分(cpm)]百分比增多,差别具有统计学意义(P＜0.01)。重度窒息组正常慢波百分比较对照组及轻度窒息组明显降低,胃动过速(＞4cpm)百分比明显增多,P＜0.01。重度窒息组比轻度组及对照组主频率不稳定系数增高,P＜0.01。普瑞博思治疗后窒息儿胃肠症状消失,正常慢波百分比较治疗前增高,胃动过速明显减少,P＜0.01。结论可通过胃电图观察窒息新生儿的胃电活动,进而研究新生儿消化道动力;国产期窒息的新生儿出现拒乳、腹胀、呕吐等症状,可能与其胃电活动异常有关;普瑞博思可以再建正常的胃电节律而有效改善窒息儿胃肠症状。     

功能性消化不良及厌食患儿的胃电节律变化

目的：厌食是儿科门诊特别是消化专科门诊中常见的主诉,小儿厌食可能与多种因素有关,该文通过对部分诊断为功能消化不良,伴有或不伴有厌食的病人进行体表胃电图监测,探讨胃电活动改变是否与厌食存在一定关系。方法：32例病人均有消化道症状,包括腹痛、腹胀、恶心、呕吐、反酸,呃逆、早饱等,根据有无厌食被分为厌食组(n=18)和非厌食组(n=14) ,所有病人进行餐前30 min,餐后120 min的体表胃电图检查,记录两组餐前餐后正常胃电主频,胃电节律过缓,胃电节律过快的百分比,主频不稳定系数,餐前/餐后主功率比。比较两组胃电图结果的各项参数。结果：①厌食组和非厌食组病人的胃电节律异常检出率分别为餐前77.8%（14/18）和78.6%（11/14）,P>0.05,餐后77.8%（14/18）和57.1%（8/14）P>0.05; ②两组胃电过缓百分比分别为餐前31.6% (10.18~45.33),48.9% (31.7~62.93),P>0.05,餐后33.4% (12.95~62.17),27.8% (7.4~48.1),P>0.05; ③厌食组餐前餐后胃电节律过速的百分比高于非厌食组,6.2% (2.78~19.43),0%(0~4.63),P<0.01, 和14.8% (4.73~28.85),1.9% (0~18.5),P<0.05; ④两组餐前餐后主频不稳定系数差异均无显著性; ⑤两组餐后/餐前主功率比差异无显著性。结论：功能性消化不良患儿发生胃电节律紊乱的比例较高,功能性消化不良伴厌食的患儿餐前餐后胃电节律过速的百分比高于不伴厌食患儿,而以餐前更明显。     

食管闭锁术后胃电图的变化

为了探讨胃食管返流是否与先天性肠道神经支配有关。方法：对１８例食管闭锁患儿和１８例正常儿进行了进行表面胃电图检查。结果；食管闭锁组中２例胃频率减慢，２例胃频率加快，但是主频率为０．０４７±０．００７Ｈｚ并无明显差异；食管闭锁组胃电图的频率分布比对照组明显增宽。     

新生儿的胃肠动力

近年的胃肠动力研究表明,小儿胃肠动力功能的成熟是在胎儿发育后期及至生后则产儿的胃肠动力特点是发育不成熟。然而,非营养性呼吸及微量喂养能促进早产儿胃肠动力的成熟。儿和应用最广泛的胃肠动力测定方法是消化道测压。新生儿常见的胃肠动力异常疾病是胃食管反流、胃轻瘫、肥厚性幽门狭窄及先天性巨结肠。最新的促胃肠动力剂是西沙比利及红霉素。     

健康新生儿的胃电图研究

目的：研究健康新生儿的胃电图。方法：20个健康足月新生儿胎龄37～39周,男11例,女9例,出生时阿氏评分平均为9.3±0.4分,无窒息,无器质性疾病,母乳喂养。采用体表胃电图,分别于出生后第1（第12小时）,7,14,21,28 天记录空腹和餐后体表胃电图各30 min。计算胃电图的以下参数: 主频、不同慢波节律的百分比、主频不稳定系数、功率比。结果：在所有新生儿均可记录到与成人类似的体表胃电图波形,新生儿出生后第1~28天餐前的正常胃电节律为（38. 2±4.9）%～（39.7±3.5）%,胃动过速节律为（23.7±5.4）%～（23.5±4.3）%,胃动过缓节律为（38.1±5.5）%～（36.8±3.9）%,不同年龄时期餐前与餐后相比无明显差别（P>0.05）。新生儿出生后第1~28天餐前主频为2.38±0.5 cpm～2.59±0.1 cpm ,餐后与餐前相比差异无显著性（P>0.05）,第14,21,28天餐前、餐后的主频较第1,7天高(P<0.05);生后第21,28天餐前、餐后的主频不稳定系数较第1,7,14天低(P<0.05),餐后与餐前相比差异无显著性（P>0.05）,生后第1～28天餐后餐前功率比差异无显著性（P>0.05）。结论：健康新生儿的胃电图参数与健康成人、儿童明显不同,胃电主频、正常胃电节律百分比较低,胃电主频随年龄增长逐渐升高。［中国当代儿科杂志,2007,9（4）：364-366］     

早期新生儿乳糖吸收不良与乳糖不耐受筛查及影响因素探讨

为了解乳糖吸收不良在新生儿早期的分布状况，本文采用醋酸铅半定量法测定了86例早期新生儿(足月儿74例、早产儿12例)的粪便乳糖及粪便pH值，结果提示：LM(乳糖吸收不良)在早期新生儿中发生率较高，达39．5％，而LI(乳糖不耐受)发生率为5．8％，说明大部分乳糖吸收不良的新生儿不伴有消化道症状。进一步分析，LM/LI的发生与分娩方式、围产期缺氧史、孕周、喂养史及性别均无关。本文随访了全部5例LI患儿，虽未经治疗，腹泻、腹胀症状多在2—3周内消失，最长1例症状持续至6周，生后3-4个月时复查粪便乳糖均转阴，同时生长发育良好。故新生儿早期的LM/LI系一个暂时性的缺乏，发育性的过程，考虑与肠粘膜发育不够成熟有关。     

窒息新生儿血清胃泌素与胃酸分泌的动态观察

为探讨不同程度窒息对新生儿胃酸分泌及胃泌素水平的影响。对25例轻度窒息新生儿、20例重度窒息的新生儿于出生后1、3、7天检测血清胃泌素和胃液基础酸排量(BAO)。结果显示重度窒息组第1、3天的血清胃泌素水平明显低于轻度窒息组，而第1天胃液基础酸排量则高于轻度窒息组。结论重度窒息新生儿血清胃泌素水平较轻度窒息新生儿明显降低，而胃液基础酸排量增高，这可能是导致新生儿喂养不耐受、易致消化道出血的原因。     

THE EFFECT OF CHLORPROMAZINE IN SEVERE HYPOXIA IN NEWBORN INFANTS

ABSTRACT. Eighteen newborn infants with severe hypoxia during the course of idiopathic respiratory distress syndrome, pneumonia, persistent fetal circulation or right diaphragmatic hernia were treated with chlorpromazine with the aim of improving arterial oxygenation by a postulated vasodilatory action on the pulmonary circulation. Fourteen of the infants improved their P_SO2 during the treatment. Nine infants died. The systematic arterial blood-pressure and the urinary output were reduced and some infants were somnolent during the initial period of treatment. No other side effects were noted. Further studies of chlorpromazine as a possible pulmonary vasodilator in newborn infants are justified.     

THE EARLY DETECTION OF PNEUMOTHORAX WITH TRANSTHORACIC IMPEDANCE IN NEWBORN INFANTS

Abstract. During the treatment of IRDS with assisted ventilation pneumothorax is a common and dangerous complication where an early diagnosis is important for the successful treatment. In this case report the continuous monitoring of transthoracic electrical impedance has proven to be a sensitive and non-invasive method to detect the development of pneumothorax long before clinical signs are manifest.     

肺表面活性物质对重症新生儿肺炎肺氧合功能的影响

为了观察肺表面活性物质（ＳＡＭ）对肺氧合功能的影响，用ＳＡＭ治疗６例重症肺炎合并呼吸衰竭的新生儿，治疗后低氧血症明显改善，１５分钟内血氧分压、血氧分压与吸入氧浓度比值及动脉肺泡氧分压比值均较治疗前有显著升高，分别由４．８±２．１升至８．４±２．７，６±４升至１０±５ｋＰａ及０．０８±０．０５升至０．１３±０．０５，差异有显著意义。１小时后，这些参数的均值仍高于治疗前。提示ＳＡＭ有迅速改善肺炎新生儿肺氧合功能的作用。     

TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS

ABSTRACT. During the first weeks after birth the transepidermal water loss was determined repeatedly in 7 infants born after 25–27 weeks of gestation, in 13 infants born after 28–30 weeks and in 14 full-term infants. All infants were appropriate for gestational age. The very pre-term infants had high evaporative water losses from their skin on their first days after birth. A gradual decrease was then observed, but after four weeks the values were still higher than those in full-term infants. The transepidermal water loss in full-term infants was unchanged during the first two weeks of life, but increased during the subsequent two weeks. The relation between evaporation rate from an interscapular skin area and ambient humidity was studied repeatedly during the first week of life in two very pre-term infants. The magnitude of evaporation decreased with increasing post-natal age, but was still dependent on the ambient relative humidity.     

BLOOD FLOW AND VENOUS DISTENSIBILITY IN THE UPPER AND LOWER EXTREMITIES OF NEWBORN INFANTS

Abstract. The electrocapacitance plethysmograph was utilized to measure peripheral blood flow and venous distensibility in 17 newborn infants and 20 adults. Measurements were made in the upper and lower extremities in each subject under identical environmental conditions. Blood flow in the forearm and calf were found to be significantly higher in infants than adults. In infants there were no significant differences in the blood flow between the upper and lower extremities. In contrast, in the adults, the blood flow was significantly higher in the upper than in the lower extremities. Similarly, venous distensibility was observed to be higher in infants than in adults. While no significant differences were observed in the venous distensibility between the upper and lower extremities in infants, the venous distensibility was found to be higher in the forearm than in the leg in adults.