| Objectives Observation analysis 90 cases of newborn with neonatal hypocalcemia clinical characteristics,analyze the risk factors for the development of neonatal hypocalcemia to understand the relationship between neonatal hypocalcemia and arrhythmia and the treatment effect of calcium,so as to provide theoretical basis for clinicaldiagnosis and treatment,a greater understanding of the cause of neonatal hypocalcemia harm,to provide positive and effective measure for the prevention of neonatal hypocalcemia at the same time.Methods A total of 253 children with complete clinical data were collected from the neonatal ward in the pediatric ward of hebei people's hospital from September 2017 to December 2019.According to the measured blood calcium concentration,thechildren were divided into the hypocalcemia group(n=90)and the non-hypocalcemiagroup(n=163).Among them,42 children with neonatal hypocalcemia and arrhythmiawere included.Children with neonatal hypocalcemia clinical characteristics and related data were retrospectively analyzed,through the SPSS software,univariate analysiswas performed on the possible influencing factors related to neonatal hypocalcemia,and multivariate analysis was performed on the factors with statistical significance in univariate analysis,with the occurrence of neonatal hypocalcemia as the dependentvariable.the possible influence factors as independent variables,establish a Logistic regression model,using SPSS software,unconditional multiple factors Logistic regressionanalysis.Results 1 Time of onset: In the hypocalcemia group,the onset time?72 hours after birth was 86 cases(95.56%),and the onset time of>72 hours after birth was 4 cases(4.44%).2 Risk factors for neonatal hypocalcemia: single factor analysis,according to the results of hypocalcemia group and non hypocalcemia in gestational age,birth weight and neonatal asphyxia,maternal gestational diabetes,newborn hypoxic ischemic encephalopathy,apnea,respiratory failure,seven kinds of factors on the comparison,the difference was statistically significant(P<0.05).Multivariate unconditional Logistic regression analysis showed that gestational age,birth weight,neonatal asphyxia,and maternal gestational diabetes mellitus were significantly correlated with hypocalcemia(P<0.05),were independent risk factors for neonatal hypocalcemia.3 Clinical characteristics of children with hypocalcemia complicated with arrhythmiaand its relationship with blood calcium concentration:among the 90 cases of children with hypocalcemia,42 cases had arrhythmia,42 cases were clinically manifested as low heart sound,and 30 cases had decreased heart rate.The electrocardiogram examination results: the number of Prolonged QT interval(full terms?0.19 s,prematures?0.20 s)was 33,8 cases with ?°atrioventricular block,1 case with ?°atrioventricular block.Among them 1 case with total blood calcium concentration<1.20 mmol/L,electrocardiogram performance for ?°block;14 cases of total blood calcium concentration fluctuations in tendency of 1.20 ~ 1.40mmol/L,electrocardiogram performance for the Prolonged QT interval and ?°atrioventricular block.27 case with total blood calcium concentration?1.40mmol/L,electrocardiogram performance for Prolonged QT interval.Children in the hypocalcemia group with arrhythmia had lower bloodcalcium levels than those in the non-arrhythmia group.Among them,the occurrence type of arrhythmia in children with neonatal hypocalcemia and arrhythmia is closelyrelated to the blood calcium concentration.4 Treatment effect of calcium: in the neonatal hypocalcemia group,electrocardiogram examination(ECG)was performed for the clinical manifestations of hypocalcemia and slow heart rate.Among them,42 cases of abnormal electrocardiogram were Prolonged QT interval,?°atrioventricular block and ?°atrioventricular block respectively.The patients were immediately treated with 10% calcium gluconate,of which40 recovered within a short time after the first dose,and the remaining 2 recovered within 2 days.The heart sounds and heart rate of the children were all normal,and the blood calcium was normal after review.Conclusions 1 The research results showed that among children with neonatal hypocalcemia,neonatal early hypocalcemia was more common,so the newborn within 72 hours after birth should be given high attention.2 The results of this study showed that the younger the gestational age,the lower the birth weight,the greater the risk of hypocalcemia in the neonates with asphyxiaand maternal gestational diabetes mellitus,the greater the risk of developing hypocalcemia,so active and effective measures should be taken to prevent the occurrence of related conditions.3 Children with neonatal hypocalcemia blood calcium concentration is lower,the more likely to happen arrhythmia,and cardiac arrhythmias type is closely related to the blood calcium concentration,the lower the blood calcium concentration,degree of arrhythmia is heavier,so to have risk factors lead to hypocalcemia of critically illpatients should be actively detect electrolytes,timely review,especially when children experience decreased heart sounds,heart rate decreased,the early performance such as easily frightened,more should be timely check,treatment,in order to avoid severe arrhythmia,even endanger children life.4 The results of the study showed that children with neonatal hypocalcemia combined with arrhythmia should be recognized as soon as possible and timely supplementcalcium,which is conducive to the recovery of arrhythmia,reduce the serious complications of neonatal hypocalcemia,and reduce the neonatal mortality.Figure[0];Table[4];Reference[86]... |
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