بررسی شیوع استرس هیپرگلیسمی در کودکان مراجعه کننده به اورژانس اطفال در شهرستان نیشابور در سال 1394

ﻣﻘﺪﻣﻪ: ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ ﺷﯿﻮع اﺳﺘﺮس ﻫﯿﭙﺮﮔﻠﯿﺴﻤﯽ در ﮐﻮدﮐﺎن ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ اورژاﻧﺲ اﻃﻔﺎل در ﺷﻬﺮﺳﺘﺎن ﻧﯿﺸﺎﺑﻮر در ﺳﺎل 1394 ﻃﺮاﺣﯽ ﮔﺮدﯾﺪ. روش ﮐﺎر: ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ از ﻧﻮع ﺗﻮﺻﯿﻔﯽ- ﻣﻘﻄﻌﯽ آﯾﻨﺪه ﻧﮕﺮ ﺑﻮد ﮐﻪ ﺑﺮوی 1484 ﮐﻮدک ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ اورژاﻧﺲ در ﺷﻬﺮ ﻧﯿﺸﺎﺑﻮر در ﺳﺎل 94 اﻧﺠﺎم ﺷﺪ. در ﺑﺮرﺳﯽ ﺷﺮح ﺣﺎل، ﻫﺮﮐﺪام از ﻣﻮارد ﺗﺐ، ﺗﺸﻨﺞ، ﮐﻢ آﺑﯽ، ﺗﻨﻔﺲ ﺑﺎﻻﺗﺮ از ﺣﺪ ﻃﺒﯿﻌﯽ و ﺑﺴﺘﺮی ﺷﺪن در ﺑﺨﺸﻬﺎی ﻣﺮاﻗﺒﺖﻫﺎی وﯾﮋه ﯾﮏ اﺳﺘﺮس ﻣﺴﺘﻘﻞ در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪ. اﻧﺪازه ﮔﯿﺮی ﻗﻨﺪﺧﻮن ﺑﻪ روش ﮔﻠﻮﮐﺰ اﮐﺴﯿﺪاز، اﻧﺰﯾﻤﯽ ﺑﺎ اﺳﺘﻔﺎده از ﮐﯿﺖ ﭘﺎرس آزﻣﻮن ﺻﻮرت ﮔﺮﻓﺖ. در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻫﯿﭙﺮﮔﻠﯿﺴﻤﯽ ﻗﻨﺪ ﺧﻮن ﻣﺴﺎوی ﯾﺎ ﺑﺎﻻی 150 ﻣﯿﻠﯽ ﮔﺮم در دﺳﯽ ﻟﯿﺘﺮ درﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪ. دادهﻫﺎ ﮐﺪﮔﺬاری ﺷﺪه و وارد ﻧﺮم اﻓﺰار spss ﻧﺴﺨﻪ 16 ﮔﺮدﯾﺪ و ﺑﺎ اﺳﺘﻔﺎده از آﻣﺎرﻫﺎی ﺗﻮﺻﯿﻔﯽ و اﺳﺘﻨﺒﺎﻃﯽ ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﺑﻪ ﻃﻮر ﮐﻠﯽ، 79 ﻧﻔﺮ از ﺑﯿﻤﺎران (5/4 درﺻﺪ) ﻗﻨﺪ ﺧﻮن ﺑﯿﺸﺘﺮ از 150 ﻣﯿﻠﯿﮕﺮم در دﺳﯽ ﻟﯿﺘﺮ داﺷﺘﻨﺪ ﺑﻪ اﯾﻦ ﻣﻌﻨﯽ ﮐﻪ دﭼﺎر اﺳﺘﺮس ﻫﯿﭙﺮﮔﻠﯿﺴﻤﯽ ﺑﻮدﻧﺪ. ﺑﺮرﺳﯽ وﺿﻌﯿﺖ دﻫﯿﺪراﺗﺎﺳﯿﻮن ﮐﻮدﮐﺎن ﻧﺸﺎن داد ﮐﻪ 5/03 درﺻﺪ از ﺑﯿﻤﺎران دﭼﺎر دﻫﯿﺪراﺗﺎﺳﯿﻮن ﺑﻮدﻧﺪ. ﺗﻔﺎوت ﻣﻌﻨﯽ داری ﻣﯿﺎن وﺟﻮد ﯾﺎ ﻋﺪم وﺟﻮد ﻫﯿﭙﺮﮔﻠﯿﺴﻤﯽ و درﺟﻪ ﺣﺮارت ﺑﺪن ﮐﻮدﮐﺎن ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ اورژاﻧﺲ اﻃﻔﺎل وﺟﻮد داﺷﺖ ( p = 0/01) (x2=38/08 ). ﻧﺘﯿﺠﻪﮔﯿﺮی: اﺳﺘﺮس ﻫﯿﭙﺮﮔﻠﯿﺴﻤﯽ روﯾﺪاد ﺑﺎﻟﯿﻨﯽ ﻧﺴﺒﺘﺎً ﺷﺎﯾﻌﯽ در ﺑﯿﻤﺎران ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ اورژاﻧﺲ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ ﻣﯽﺑﺎﺷﺪ. ﻫﺮﭼﻨﺪ ﻣﺸﺨﺺ ﻧﯿﺴﺖ ﮐﻪ ﮐﺪام ﺑﯿﻤﺎرﯾﻬﺎ ﺑﯿﺸﺘﺮ ﺑﺎ اﺳﺘﺮس ﻫﯿﭙﺮﮔﻠﯿﺴﻤﯽ ﻫﻤﺮاه ﻫﺴﺘﻨﺪ؛ اﻣﺎ ﺑﻪ ﻃﻮر آﺷﮑﺎری ﺑﯿﻦ ﺗﺐ و درﺻﺪ ﮐﻢ آﺑﯽ ﺑﺎ ﺑﺮوز اﺳﺘﺮس ﻫﯿﭙﺮﮔﻠﯿﺴﻤﯽ ارﺗﺒﺎط وﺟﻮد دارد.

Frequency of Hyperglycemia Stress in Pediatric Emergency Children in Neyshabur

Introduction: This study aimed to investigate the prevalence of hyperglycemia stress in children referred to the pediatric emergency department in Neyshabur city in 2015. Methods: This descriptivecrosssectional prospective study was conducted on 1484 children referred to emergency department in Neyshabur city. Clinical biography involving fever, seizure, dehydration, abnormal respiration, and admission to ICUs were considered as an independent stress. Blood glucose measured using glucose oxidase, enzyme, which was analyzed using Pars Azmoon kits. In this study, ge;150 mg/dL blood sugar was considered as hyperglycemia. The data were coded and entered into SPSS software version 16 and analyzed using descriptive and inferential statistics. Results: In general, 79 patients (5.4%) had blood glucose greater than 150 mg/dL, that they were diagnosed with hyperglycemia. Also, 5.03% of children were identified with dehydration. There was a significant difference between the presence and absence of hyperglycemia and body temperature in children referred to the pediatric emergency department ( chi;2= 38.8) (P= 0.01). Conclusions: Hyperglycemia stress is a common clinical event in patients referred to the emergency department. Although risk factor associated with hyperglycemic stress is not completely identified, there is a relationship between fever and dehydration with stress hyperglycemia