Harris Deborah L, Weston Philip J, Battin Malcolm R, Harding Jane E
Liggins Institute, University of Auckland, Newborn Intensive Care Unit, Waikato District Health Board, Hamilton and Newborn Services, Auckland City Hospital, Auckland, New Zealand.
J Paediatr Child Health. 2014 Oct;50(10):E55-62. doi: 10.1111/j.1440-1754.2009.01599.x. Epub 2009 Oct 26.
Neonatal hypoglycaemia is a common problem linked to both brain damage and death. There is controversy regarding both the definition of and best treatment for neonatal hypoglycaemia.
To determine current management of neonatal hypoglycaemia within the Australian and New Zealand Neonatal Network (ANZNN).
Four questionnaires were sent to the Director of each of the 45 nurseries within the ANZNN. The Director was asked to complete one questionnaire and give the remaining three to other doctors involved with the management of babies with hypoglycaemia in the nursery.
One hundred and eighty surveys were sent and 127 were returned (71%), including at least one from each nursery. Almost all respondents (120, 94%) reported using a protocol to treat hypoglycaemia. Only 2 (2%) reported screening all babies for neonatal hypoglycaemia, with the remainder screening babies at risk. Only 67, (53%) reported that blood glucose levels were tested on an analyser generally considered to be reliable at low levels. Most respondents (99, 78%) reported the clinical threshold for treatment was <2.6 mmol/L. However, when provided with clinical scenarios, respondents reported a variety of interventions, including no treatment.
Doctors within the ANZNN are consistent about definition and screening for neonatal hypoglycaemia. However, frequently, the diagnosis is made using unreliable analysers. There is also wide variation in treatment, suggesting a lack of reliable evidence on which to base practice.
新生儿低血糖是一个与脑损伤和死亡相关的常见问题。关于新生儿低血糖的定义和最佳治疗方法存在争议。
确定澳大利亚和新西兰新生儿网络（ANZNN）内新生儿低血糖的当前管理情况。
向ANZNN内45家托儿所的每位主任发送了四份问卷。要求主任填写一份问卷，并将其余三份问卷分发给托儿所内其他参与低血糖婴儿管理的医生。
共发送了180份调查问卷，回收了127份（71%），每个托儿所至少有一份问卷被回收。几乎所有受访者（120人，94%）报告使用了治疗低血糖的方案。只有2人（2%）报告对所有婴儿进行新生儿低血糖筛查，其余则对有风险的婴儿进行筛查。只有67人（53%）报告血糖水平是在一般认为低水平时可靠的分析仪上进行检测的。大多数受访者（99人，78%）报告治疗的临床阈值为<2.6 mmol/L。然而，当给出临床病例时，受访者报告了各种干预措施，包括不进行治疗。
ANZNN内的医生在新生儿低血糖的定义和筛查方面是一致的。然而，诊断经常使用不可靠的分析仪。治疗方法也存在很大差异，这表明缺乏可靠的证据来指导实践。
