围生期窒息新生儿二氧化碳分压和pH值改变与神经系统损害的关系  

Study on the changes in blood gas and neurologic injury in newborn infants with perinatal asphyxia.

作　　者：肖春香[1] 

机构地区：[1]南华大学第一附属医院,衡阳421001

出　　处：《中国实用儿科杂志》2005年第7期425-426,共2页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨围生期窒息新生儿PaCO2及pH快速变化及其与神经系统损害之间的关系。方法2002年1月至2003年12月南华大学第一附属医院将55例足月窒息新生儿分为3组组Ⅰ,pH>7.00,无神经系统异常,无需呼吸支持;组Ⅱ,pH≤7.00,余同组Ⅰ;组Ⅲ,pH≤7.00,神经系统异常,需辅助呼吸支持。采集脐动脉血、产后1h和2h桡动脉血进行血气分析并观察Apgar评分和临床经过。结果脐动脉血pH值和PaCO2各组间差异有显著性;产后1h动脉血pH组Ⅰ、Ⅲ间和组Ⅱ、Ⅲ间差异有显著性;产后1h动脉血pH、PaCO2分别和脐动脉血pH、PaCO2比较,差异有显著性;三组间有不同的神经系统表现;Apgar评分组Ⅲ较低。结论在严重酸中毒时,胎儿出生后pH、PaCO2会发生显著改变,需持续辅助机械通气的患儿有不良的神经系统预后。Objective To explore the relationship between the rapid changes in CO_2 and pH value and neurologic injury in asphyxia infants in presence of severe academia.Methods Umbilical arterial blood and radial arterial blood at postnatal 1,2h were checked in 55 infants.These infants were categortized in three groups:Ⅰ,pH>7.00,normal neurologic examination without respiration support;Ⅱ,identification to Ⅰexcept pH≤7.00;Ⅲ,pH≤7.00,abnormal neurologic examination with mechanical ventilation.Results Umbilical arterial blood pH was significantly different in Ⅲ vs Ⅰ and in Ⅱ vs Ⅲ.PaCO_2 was significantly different in Ⅲ vs Ⅱ vs Ⅰ.At postnatal 1h pH increased and PaCO_2 decreased in all groups,significant differences in three group remained.At postnatal 2h,no differences were observed for pH and PaCO_2 in Ⅱand Ⅲ,there was different neurologic prognosis among groups.Apgar score was lower in Ⅲ.Conclusion After delivery pH and PaCO_2 have rapid changes in presence of severe academia.Lower pH and Apgar score with mechanical ventilation are poor prognosis factors of neurologic result.

关 键 词：窒息 酸中毒 血气分析 新生儿 

分 类 号：R72[医药卫生—儿科]