m*****c
发帖数: 13 | 1 【 以下文字转载自 NextGeneration 讨论区 】
发信人: mybasic (for life), 信区: NextGeneration
标 题: [求助] 宝宝的了重病------update
发信站: BBS 未名空间站 (Tue Sep 6 18:37:56 2011, 美东)
update
目前诊断是先天性垂体功能降低，虽然MRI 现实垂体正常，但是不协调分泌激素。
想不通为什么脑垂体有问题，影响了整个生长。
目前正在用hydrocortisone
生长素目前很低，但是不到能用药的程度，以后看是否会用生长素激素。
-------------------------------
求助，宝宝刚出生就进了NICU，麻烦有经验的父母或者医生，给点意见。
1.宝宝刚出生呼吸突然停止，脸发青，上了氧气抢救。然后呼吸一直急促，血糖低<20
，心跳慢.
2.SpO2 每隔一两个小时左右就会降到60以下，大部分时间两分钟之内可自行恢复到90.
偶尔给氧气.
2.刚出生在医院里连续输了三天葡萄糖和抗生素 （妈妈GBS positive，生产过快疫苗
来不急）。刚出生葡萄糖浓度12.5％才能维持正常血糖。
3.第三天出现黄疸，照蓝光，Bili一致在15和10之间反复了，现在降到了10.
4.现在10天了，呼吸和血糖趋于稳定。最近几天喂食前都做血糖测试，会在40～100之
间浮动。但和刚出生相比，吃奶无力，呼吸急促，哭声弱。肌张力弱并有恶化趋势。每
天喂养8次，每次50～60 oz breast milk or fomula。
5.脑部US，MRI正常。听力正常。
5.甲状腺T4,TSH目前测试正常，但是每周有下降的趋势。
6.第七天，医生说缺少hydrocortisone，给了hydrocortisone，正在观察是否有效。目
前看吃奶改善，以前1小时现在半小时吃奶时间。
7.已经送出血样、尿样做基因和代谢检查，结果还没出来。
8.怀孕20几周发现宝宝双脚clubfeet，做羊穿基因测试正常。40周按时生产。重
7lb12oz。
恳请各位xdjm帮忙看看宝宝是什么问题。 | L****n
发帖数: 12932 | | A*******s
发帖数: 9638 | 3 我google了一下， 希望有所帮助：
Most neonates with hypopituitarism have normal or even high birth weights
and lengths and no history of intrauterine growth retardation. However, they
often have histories of breech presentation (particularly neonates with
MPHD), although the explanation for this is unclear. Microgenitalia, mainly
in males, may result from a gonadotropin deficiency or from GH deficiency.
The hypoglycemia risk is higher in neonates with hypopituitarism, with
various manifesting symptoms, such as lethargy, jitteriness, pallor,
cyanosis, apnea, or convulsions. Jaundice may be secondary to indirect
hyperbilirubinemia (as occurs in TSH axis deficiency) or to direct
hyperbilirubinemia (as occurs in GH or ACTH axis deficiencies).
Neonates with hypopituitarism may have undergone several evaluations to
exclude sepsis or for unexplained apnea, hypotension, or temperature
instability. Consider hypopituitarism as a possible diagnosis when these
conditions occur in a full-term infant.
Electrolyte disturbances can also occur in neonates with hypopituitarism.
Hyponatremia unassociated with hypovolemia and unresponsive to fluid
restriction can develop. In contrast to the hyponatremia that occurs with
the salt-losing crisis of 21-hydroxylase deficiency, serum potassium levels
are typically low or within the reference range. The hyponatremia resolves
with physiologic corticosteroid replacement.[18] Hypernatremia secondary to
excess free-water loss associated with uncontrolled diabetes insipidus may
also occur.
Depending on the etiology of the hypopituitarism, associated findings in the
neonate, infant, or child may include developmental delay, various visual
and neurologic symptoms, seizure disorder, and a number of congenital
malformation syndromes. |
|
