Giroux J D, Vernotte E, Gagneur A, Metz C, Collet M, de Parscau L
Service de néonatologie, CHU Morvan, Brest, France.
Arch Pediatr. 1997 Dec;4(12):1213-6. doi: 10.1016/s0929-693x(97)82612-7.
Hypoglycemia is a well-known complication in neonates small for gestational age and in those with diabetic mothers. Birth asphyxiated infants can develop severe hypoglycemia due to reduced glycogen stores.
The first patient was born at 41 weeks, weighing 3,780 g by emergency cesarean section because of fetal distress. He developed a pneumothorax and hypoglycemia. He was given glucose infusion (at day 4: 20 mg/kg/d). Hyperinsulinism was confirmed: blood levels at 18.3 mU/L on day 1 and 11.7 mU/L on day 2. The infusion rate was gradually decreased. The second patient was born at 39 weeks, weighing 2,780 g by emergency cesarean section because of fetal distress. She needed glucose infusion (24 g/kg/d) because of hypoglycemia with hyperinsulinism (12.8 mU/L on day 2 and 11.7 mU/L on day 3). After 5 days, the infusion of glucose was replaced by oral feeding only.
Transient hypoglycemia in asphyxiated newborn infants with hyperinsulinism must be considered even when hypoglycemia may be difficult to prove.
低血糖是小于胎龄新生儿和患有糖尿病母亲的新生儿中一种众所周知的并发症。出生窒息的婴儿由于糖原储备减少可发生严重低血糖。
首例患者孕41周，因胎儿窘迫行急诊剖宫产，出生体重3780克。他出现气胸和低血糖。给予葡萄糖输注（第4天：20毫克/千克/天）。确诊为高胰岛素血症：第1天血胰岛素水平为18.3毫国际单位/升，第2天为11.7毫国际单位/升。输注速率逐渐降低。第二例患者孕39周，因胎儿窘迫行急诊剖宫产，出生体重2780克。她因低血糖伴高胰岛素血症（第2天为12.8毫国际单位/升，第3天为11.7毫国际单位/升）需要葡萄糖输注（24克/千克/天）。5天后，葡萄糖输注改为仅经口喂养。
即使低血糖可能难以证实，对于伴有高胰岛素血症的窒息新生儿，也必须考虑短暂性低血糖。
