【摘要】：目的:觀察低胎齡早產(chǎn)兒生后2周內(nèi)補(bǔ)充鈣、磷后腎功能電解質(zhì)及尿檢驗(yàn)指標(biāo)變化及其臨床意義。方法:2013年1月-2015年8月在本院新生兒科住院的33周的早產(chǎn)兒共102例,其中35例為胎齡28~30周,67例為胎齡30~32周。按入院先后順序分成4組:對(duì)照組、單純補(bǔ)鈣組、單純補(bǔ)磷組、鈣磷同補(bǔ)組,除對(duì)照組外,余三組均在生后第2天開始按以上分組補(bǔ)充鈣磷至生后14d。分別于出生7、14d抽血檢測(cè)腎功能、血清鈣、磷水平;留尿檢測(cè)尿常規(guī)、尿鈣水平,有鏡下血尿者查尿肌酐。結(jié)果:(1)對(duì)照組:生后第2周未補(bǔ)充鈣磷,部分出現(xiàn)低磷血癥,以28~30周胎齡兒尤為明顯,腎功能均正常。(2)單純補(bǔ)鈣組:部分早產(chǎn)兒出現(xiàn)鏡下血尿,尿鈣/肌酐比值提示高鈣尿癥,血肌酐輕度升高提示腎功能損害,且以28~30周胎齡兒尤為明顯,但血鈣磷并無異常。(3)單純補(bǔ)磷組:部分早產(chǎn)兒出現(xiàn)低鈣血癥,以28~30周胎齡兒尤為明顯,腎功能均正常。(4)鈣磷同補(bǔ)組:合適比例的鈣磷同補(bǔ),能維持血鈣磷平衡、腎功能正常、尿檢正常。結(jié)論:生后第2周未補(bǔ)充鈣磷,可能出現(xiàn)低磷血癥;單純補(bǔ)鈣可能導(dǎo)致高鈣尿癥及腎功能損害;單純補(bǔ)磷,易出現(xiàn)低鈣;以上情況均以28~30周胎齡兒尤為明顯。而合適比例的鈣磷同補(bǔ)能促血鈣磷平衡,避免腎功能損害。
[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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