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本文报导我院1981年9月至1983年1月收治的新生儿低镁惊厥17例。仅2例为母乳喂养。如不测定血镁,低镁血症与低钙血症的症状和体征无法鉴别。我们测定了50例正常儿童的血清镁浓度,其平均值——2个标准差=2.17-2×0.34=1.49毫当量/升。我们暂定血镁<1.48毫当量/升为低镁血症。17例患者血清镁浓度为0.65-1.46毫当量/升。10例血清钙浓度<7毫克/100ml。测定血清磷浓度8例,其中5例76毫克/100ml。一般静脉滴注2.5％硫酸镁2—4毫升/公斤体重,每天两次。惊厥停止后,改用肌肉注射25％硫酸镁0.4毫升/公斤体重,每天两次。往往在应用硫酸镁1—4次后,惊厥得到控制,而血清镁浓度要在用硫酸镁2—6天后才升至正常。5例患者同时有低钙血症和低镁血症。反复应用葡萄糖酸钙,惊厥未得到控制,仅在应用硫酸镁后,血清钙浓度才升至正常水平,惊厥停止。有7例患儿检查过心电图,除1例正常外,6例均异常。因此,镁对心脏的影响应予重视。
This article reports from our hospital from September 1981 to January 1983 admitted to neonatal low magnesium convulsions in 17 cases. Only 2 cases were breastfeeding. If not measured blood magnesium, hypomagnesemia and hypocalcemia symptoms and signs can not be identified. We measured serum magnesium concentrations in 50 normal children with an average of 2 standard deviations = 2.17-2 × 0.34 = 1.49 meq / l. We tentatively set blood magnesium <1.48 meq / L to hypomagnesemia. Seventeen patients had a serum magnesium concentration of 0.65-1.46 meq / l. 10 cases of serum calcium concentration <7 mg / 100ml. Serum phosphorus concentration was measured in 8 cases, of which 5 cases of 76 mg / 100ml. General intravenous infusion of 2.5% magnesium sulfate 2-4 ml / kg body weight twice daily. After the seizures stopped, she switched to intramuscular injection of 25% magnesium sulfate 0.4 ml / kg body weight twice daily. Convulsions are often controlled after 1-4 doses of magnesium sulphate, whereas serum magnesium concentrations increase to normal after 2-6 days with magnesium sulphate. Five patients had both hypocalcemia and hypomagnesemia. Repeated application of calcium gluconate, convulsions were not controlled, only after the application of magnesium sulfate, serum calcium concentrations rose to normal levels, seizures stopped. There are 7 cases of children checked electrocardiogram, except one case of normal, 6 cases were abnormal. Therefore, the impact of magnesium on the heart should be given priority.