新生兒低鈣血癥英文版

NeonatalhypocalcemiaEnglishversion匯報(bào)人：2023REPORTINGIntroductionClinicaldeclarationDiagnosisanddifferentialdiagnosisTreatmentandPreventionPrognosisandoutcomeResearchprogressandprospects目錄CATALOGUE2023PART01Introduction2023REPORTINGDefinitionNeonatalhypercalcemiareferstoadecreaseinbloodcalciumlevelsinnewborns,commonlydefinedasaserumcalciumconcentrationoflessthan2.25mmol/L(8.8mg/dl)inthefirstweekoflifeCharacteristicsNeonatalhypocalcemiacanmanifestwithavarietyofsymptoms,includingmuscletremors,tweeting,controversies,andpoorfeedingItmayalsoleadtopoorgrowthanddevelopmentinthelongtermDefinitionandCharacteristicsCalciumtransportDuringpregnancy,thefetusacquiredcalculusfromthemotherthroughtheplateauAfterbirth,thenecessarystarttoregulatecalciumabsorptionandincreasetomaintainnormalbloodcalciumlevelsEndocrinechangesTheneonate'sendocrinesystemisnotfullydeveloped,leadingtochangesinhormonelevelsthataffectcalciumregulationOtherfactorsOtherfactorsthatmaycontributetoneonalhypocalcemiaincludeprecision,lowbirthweight,andgeneticpredispositionPathogenesisIncidentTheincidentofneonalhypercancemiaisrelativelyhigh,affectingapproximately30%ofneonatesPrematurity,lowbirthweight,andcesareansectiondeliveryareriskfactorsfortheconditionPrognosisInmostcases,neonalhypercemiaistransientandresolvessporadicallywithinafewdaysHowever,multiplecasesmayrequiretreatmenttopreventlongtermsequencesEpidemiologyPART02Clinicaldeclaration2023REPORTINGIrritabilityandresistanceBabieswithhypocalcemiamaydisplayincreasedcrying,jitteriness,anddiversecallingdownSeizuresorconclusionscanbeaseriessymptomofhypocalcemiainneonatesThemusclesofthebabymaybeweakandtheremaybevisibletremorsBabiesmayhavediversitylatchingontothebreadorbottomandmaytireeasilywhilefeedingConvulsionsWeaknessandmuscletremorsDiversityinsmokingSymptomsAslowheartrateisoftenobservedinbabieswithhypocalcemiaBradycardiaThebabymaybreakthequicklyandshallowlyHyperventilationSeizuresorconclusionscanbeaseriessignofhypocalcemiainneonatesConvulsionsThebabymaybelethargic,drowsy,ordifficulttorouteAlternativeconsensusSignsABCDComplicationsDevelopmentaldelayLongtermuntreatedhypocemiacanleadtodevelopmentaldelayinfansCardiacarrhythmiasBradycardiaandarrhythmiascanleadtoCardiacarrestinmultiplecasesofhypocalcemiaPersistentseizureactivitySeizesthatpersistentdeserttreatmentcanleadtolongtermneurologicalsequelaeDeathInextremecases,neonalhypercemiacanbelifethreadingandresultindeathPART03Diagnosisanddifferentialdiagnosis2023REPORTINGReducedserumcalciumlevelSerumcalciumlevelshouldbemeasuredinnewbornstodiagnosehypocalcemiaAserumcalculuslevelbelow2.5mmol/L(normalrange:2.5-2.9mmol/L)isdiagnosticforhypercancemiaSymptomsandsignsSymptomsandsignsofhypocalcemiamayincludepoorfeeding,lethargy,hypotonia,irritability,andsizeThesesymptomsmaybepresentatbirthordevelopwithinthefirstfewdaysoflifeDiagnosticcriteriaHypercalcemiaisarareconditioninnewborns,butitshouldbeconsideredinthedifferentialdiagnosisofhypercalcemiaHypercalcemiamaybecausedbyhyperparathyroidismorhypervitaminosisDHypercalcemiaHypomagnesemiacanmixthesymptomsofhypocalcemiaSerummagnesiumlevelshouldbemeasuredinnewbornswithsuspectedhypocalcemiatoexcludehypocalcemiaasacauseHypomagnesemiaDifferentialdiagnosisSerumcalcium,phorus,magn…Serumlevelsofthesemineralsandenzymesshouldbemeasuredtoconfirmthediagnosisofhypocalcemiaandassesstheseverityofthecondition要點(diǎn)一要點(diǎn)二25hydroxyvitaminDlevelThe25hydroxyvitaminDlevelshouldbemeasuredtoexcludehyperthyroidisisDasacauseofhypocancemiaLaboratoryexaminationPART04TreatmentandPrevention2023REPORTINGImmediatetreatmentOnceneonalhypocalcemiaisdiagnosed,immediatetreatmentshouldbestartedtoavoidfurtherdamagetothebaby'snervoussystemCorrectionofcalculuslevelsThemaingoaloftreatmentistocorrectthecalculuslevelsinthebloodtonormalrangeassoonaspossibleThiscanbeachievedbygivingcalciumsuppliesorallyorintravenouslyMonitoringClosemonitoringofthebaby'sconditionisessentialduringtreatmenttoensurethatthescalelevelsarestableandtodetectanyadversereactionstothetreatmentTreatmentprinciplesTreatmentplanOralcalculussupplies:Ifthebaby'sconditioniscoldandthecauseofhypocalcemiaistemporary,oralcalculussuppliesmaybesufficienttocorrectthecalculuslevelsThedoseanddurationoftreatmentshouldbebasedonthebaby'sweightandtheseverityofhealthcareIntrinsiccalciuminfusion:Ifthebaby'sconditionissevereororaltreatmentisnoteffective,invasivecalciuminfusionmaybenecessaryThisinvolvesgivingaconcentratedsolutionofcalculusdirectlyintoaveinThefusionrateanddurationshouldbecarefullycontrolledtoavoidoverdoseoradversereactionsOthertreatmentmeasures:Insomecases,othertreatmentmeasuresmayberequiredtocorrecthypercancemia,soasstoppinganybugsthatmaybecausingtheconditionortreatinganyunderlyingdiseasesthatmayberesponsiveforthehypercancemiaRoutescreening01RoutescreeningofnewbornsforhealthcareshouldbecarriedouttoidentifythoseatriskandinitiatetreatmentearlyMaterialnutrition02EnsuringthatexpectedmothershaveequalcalculusintakeduringpregnancycanhelppreventhypocalcemiainnewbornsAvoidingdrugs03AvoidingtheuseofdrugsknowntocausehypocalcemiaduringpreheatingandbreakfeedingcanhelppreventneurologicalhypocalcemiaPreventivemeasurePART05Prognosisandoutcome2023REPORTINGIfhypocalcemiaisdiagnosedearlyandtreatedpromptly,theshorttermdiagnosisisgenerallygoodThebaby'ssymptomsmayresolvequicklyandthereisalowriskofcomplicationsRapidtreatmentresponseEvenwithprompttreatment,it'sessentialtocontinueclosemonitoringofthebaby'sconditionThisincludesregularassessmentsofthebaby'sscalelevelsandanyotherassociatedhealthissuesClosemonitoringrequiredShorttermdiagnosisWithappropriatetreatmentandmonitoring,mostbabieswithneonalhypercancemiawillachievenormalgrowthanddevelopmentHowever,it'sessentialtoensurethattheunderlyingcauseofthehypocalcemiaisalsotreatedtopreventrecurrenceNormalgrowthanddevelopmentAlthoughray,thereisariskoflongtermeffectssuchasdevelopmentaldelay,learningdifficulties,orbehavioralproblemsBabieswhoexperiencemultipleorprolongedhypocalcemiaareatincreasedriskoftheseeffectsPotentiallongtermeffectsLongtermdiagnosisTheseverityofhypocalcemia,bothintermsofdurationanddegreeofcalciumdeficiency,isakeyfactorindeterminingthediagnosisMidcaseswithshortdurationaregenerallyassociatedwithabetterprognosisThediagnosiscanbeinfluencedbytheunderlyingcauseofhybridizationSomecauses,suchasinheriteddisordersormultipleintrauterinegrowthrestrictions,mayhaveapoordiagnosisthanothersThepromptdiagnosisandtreatmentofhepatocellularcansignificantlyimprovethediagnosisBabieswhoreceivetreatmentearlyarelessliketoexperiencelongtermeffectscomparedtothosewhoreceivedelayedtreatmentSeverityofhypocalcemiaUnderlyingcauseTimelydiagnosisandtreatmentInfluencefactorPART06Researchprogressandprospects2023REPORTINGScientistsareactivelyexploringnewdrugsthatcaneffectivelytreatneonalhypercemiawithFewersideeffectsDiscoveryofnewdrugsResearchersareconductingindepthstudiesonthemechanismofactionofnewdrugstobetterunderstandtheirthermaleffectsandpotentialrisksDrugmechanismresearchCombinationtherapyusingmultipledrugsmayprovidemoreeffectivetreatmentoptionsforneonatalhypercemiaDrugcombinationtherapyNewdrugresearchInitialsafetyandtolerancestudiestoevaluatethesafetyprofileofnewbugsinasmallgroupofhealthyvolunteersPhaseItrials