Takahashi N, Hoshi J, Nishida H
Maternal and Perinatal Center, Tokyo Women's Medical College, Japan.
Acta Paediatr Jpn. 1994 Jun;36(3):250-5. doi: 10.1111/j.1442-200x.1994.tb03173.x.
There are few reported studies of water balance and electrolyte abnormalities in extremely low birthweight (ELBW) infants weighing < 1000 g nursed in high humidity. We retrospectively analyzed water balance, electrolyte and acid-base balance in 100 ELBW infants, of whom 72 were appropriate for gestational age (AGA) and 28 were small for gestational age (SGA). They were cared for in closed incubators at almost full ambient humidity. Fluid intake was restricted to 50-60 mL/kg on the first day of life and was adjusted to maintain normal serum Na concentration. Weight loss in AGA and SGA infants was 21.6 and 16.7%, respectively, and was associated with large urine volume rather than insensible water loss. The incidence of hypernatremia (> 150 mEq/L) and hyponatremia (< 130 mEq/L) was 8.0 and 33.3%, respectively. The incidence of hyperkalemia in AGA infants was 37.0%, and 14.8% in the SGA group. However, hyperkalemia requiring treatment was rare. The incidence of late metabolic acidosis in AGA and SGA infants was 84.6 and 37.5%, respectively (P < 0.01). The difference in water balance and electrolyte abnormalities in AGA and SGA infants needs to be taken into account in managing ELBW infants.
关于出生体重极低（ELBW，<1000g）的婴儿在高湿度环境中护理时的水平衡和电解质异常情况，鲜有研究报道。我们回顾性分析了100例ELBW婴儿的水平衡、电解质及酸碱平衡情况，其中72例为适于胎龄儿（AGA），28例为小于胎龄儿（SGA）。他们在几乎完全的环境湿度下于密闭暖箱中护理。出生第一天液体摄入量限制在50 - 60 mL/kg，并根据血清钠浓度进行调整以维持正常水平。AGA和SGA婴儿的体重减轻分别为21.6%和16.7%，且与尿量多有关，而非不显性失水量。高钠血症（>150 mEq/L）和低钠血症（<130 mEq/L）的发生率分别为8.0%和33.3%。AGA婴儿高钾血症的发生率为37.0%，SGA组为14.8%。然而，需要治疗的高钾血症很少见。AGA和SGA婴儿晚期代谢性酸中毒的发生率分别为84.6%和37.5%（P<0.01）。在管理ELBW婴儿时，需要考虑AGA和SGA婴儿在水平衡和电解质异常方面的差异。
