The diagnosis and treatment of hypokalemia-related soft disease and arrhythmias. ③ The process of potassium entering cells to reach a certain balance is slow, requiring over 15 hours. In severe hypokalemia cases, it may take 15-20 days for intracellular balance, so oral or intravenous potassium supplementation should last several days without being too hasty or stopping halfway. For instance, one case in this group was supplemented with 9g of potassium chloride daily for 20 days, after which serum potassium levels and ECG readings returned to normal completely. ④ When supplementing potassium, renal function should be considered, and urine output should be greater than 509ml/day. ⑤ If hyperchloremia (such as renal tubular acidosis) or liver dysfunction occurs, potassium glutamate or potassium magnesium aspartate can be used, while gastrointestinal discomfort can be managed with citric acid potassium. ⑥ Patients with hypokalemia-induced soft disease should strictly rest in bed, avoid rushing to get out of bed and walk to prevent relapse. (Received on April 25, 1997)
Pediatric Hypoxic Ischemic Encephalopathy (23 Cases)
Luning Lu, Pa.
Hypoxic-ischemic encephalopathy (HIE) refers to brain damage caused by hypoxia-ischemia during perinatal asphyxia, characterized mainly by cerebral edema, softening, necrosis, and hemorrhage, with severe cases often leading to sequelae. This study analyzes 23 confirmed pediatric HIE cases from the hospital's clinical and brain CT data to improve understanding of the disease.
Materials and Methods:
A. Study Group: This group consisted of 23 cases, including 14 males and 9 females, with three preterm infants and 18 full-term infants. Age at birth ranged from 1 hour to 7 days.
B. Diagnostic Criteria: Based on the 1989 Jinan meeting standards.
C. CT Machine: Siemens SOMATOM C body CT with conventional orbitomeatal line (OM) upward axial continuous scanning of 8-10mm thickness layers.
D. Clinical Manifestations: Consciousness changes, muscle tone, breathing changes, primitive reflexes, and associated symptoms were observed. Cases were divided into mild, moderate, and severe categories. Muscle tension increased in 14 cases (60.8%), decreased in 3 cases (13%), and lower primitive reflexes disappeared in 14 cases (60%). Associated symptoms included fecal inhalation syndrome (8.6%), scleredema (4.3%), neonatal jaundice (17.3%), pneumonia (26%), and neonatal bleeding plague (4.3%). Eighteen cases underwent EEG, with eight showing abnormalities.
E. CT Performance: Divided into mild, moderate, and severe performance based on scattered focal low-density films distributed across two lobes of the brain, moderate low-density films covering more than two lobes, severe gray matter loss, contrast mode changes, basal ganglia and cerebellum normal density, and ventricle compression.
F. Distribution: Mild cases involved four frontal lobe cases, two parietal lobe cases, and four frontal-parietal lobe cases. Moderate cases mainly affected the frontal and parietal lobes, with subarachnoid hemorrhage in some cases, two subdural hematoma and subdural effusion cases. Severe cases showed diffuse low-density shadows in the brain parenchyma, with gray matter boundary loss and right temporal-parietal cerebral hemorrhage.
G. Density Changes: Chest CT showed low density with values ranging from 16 to 29Hu, cerebral hemorrhage increased CT value to 74Hu, requiring window width and level adjustments for further observation.
H. Lesions: Mild cases mainly involved one to two brain lobes, limited in scope, while moderate to severe cases often exceeded two brain lobes, with unclear lesion boundaries, bleeding, and a range approximately 8.8 x 2.1 x 3cm.
I. Ventricular Changes: Five mild cases showed no change in the third ventricle side of the brainstem symmetry, one case had mild lateral body compression, and severe cases showed significant lateral ventricle compression.
J. Contrast Brain CT Grading and Clinical Grading Schedule.
K. Discussion: Neonatal children with hypoxic ischemic encephalopathy have a clear history of perinatal hypoxia, especially severe asphyxia, with most symptoms appearing within days after birth, characterized by altered consciousness, hypotonia, and apnea-based units.
CT Room, People’s Hospital of Sanmenxia City, Henan College of Traditional Chinese Medicine