Clinical Study Of The Damaging Effects Of Asphyxia On Neonatal Heart And Brain And The Changes Of Serum Electrolyte

Objective:To research the changes of BAEP,CT,CK-MB,serum electolyte in the neonatal asphyxia and the value in the diagonosis of the asphyxiated neonates.Methods:60 cases of full-term asphyxiated neonates were given brainstem auditory evoked potential(BAEP) and craniocerebral CT examination respectively within a week after birth.They were also given electrocardiogram examination and the determination of serum,creatine phosphokinase(CK),MB isoenzyme of creatine kinase(CK-MB),potassium,sodium,chloride,serum calcium,iconized calcium and magnesium.Result:1,The occurrence rates ofⅠ,Ⅲ,Ⅴwaves of BAEP of the asphyxiated group were 92.50%,93.33%,84.17%respectively with a prolonged period of latency(PL) (P＜0.05).The interpeak period of latency(IPL) ofⅠ-Ⅲ,Ⅰ-Ⅴ,Ⅲ-Ⅴincreased and their response thresholds roseo(P＜0.05) The abnormality of craniocerebral CT was mainly reflected in brain edema,intracerebral low density and intracranial hemorrhage.41 cases,68.33%of the 60 asphyxiated were abnormal in craniocerebral CT or BAEP examination.Among these abnormal cases,8cases were abnormal only in craniocerebral CT,7 only in BAEP and 26abnormal in both.2,In the comparison of myocardial enzymes between neonates with severe asphyxia and neonates with light asphyxia,each enzyme of the severe was significantly higher than that of the light.(P＜0.05)There were 38 cases with abnormal electrocardiogram among which 17 had only abnormal myocardial,no solely abnormal case in electrocardiogram examination and 38 cases abnormal in both within 12—96 hours in asphyxiated group.3,Among all these 60 full-term asphyxiated neonates,serum potassium of 9 cases,15%of the whole was higher than 5.5mmol/L,serum sodium of 38 cases,63.33 %of the whole was lower than 130mmol/L,serum chlorine of 26,43.33%of the whole lower than 96mmol/L,serum calcium of 41,68.33%of the whole lower than 1.8mmol/L,free calcium of 44,73.33%of the whole lower than 0.9mmol/L,serum magnesium of 7,11.67%of the whole lower than 0.6mmol/L.There was significant positive correlation between asphyxia and serum sodium potassium,serum chlorine and free calcium and there was significant difference between these two asphyxiated and control groups.(P＜0.01) The decrease of free calcium was more significant than that of general calcium and there was no significant correlation between serum potassium,serum magnesium and the degree of asphyxia,so there was no significant difference between these two groups.(P＞0.05).Conclusion:Asphyxiated neonates may suffer from brain and heart damage and electolyte disorder.So1,There was BAEP anomaly in asphyxiated neonates and anomaly rates of the severe patients were higher than those of the light.2,The anomaly Craniocerebral CT rates of asphyxiated neonates rose and the The anomaly rates of the severe asphyxiated neonates were higher than those of the light.3,There is an overlap of 43.33%between BAEP anomaly and Craniocerebral CT anomaly so a combined examination could improve the detectable rates of the cerebral damage.4,The myocardial enzymes of asphyxiated neonates rose significantly and the rising rates of the severe asphyxiated neonates were higher than those of the light. The rise of myocardial enzymes is in correlation with the change of Electrocardiogram.5,Serum sodium,chlorine,calcium and iconized calium of the asphyxiated neonates fell and the decrease degree of Serum sodium,chlorine,calcium and iconized calium in the severe asphyxiated neonates was higher than in the light.There was no significant correlation between serum potassium,serum magnesium and the asphyxia degree.