围生期窒息新生儿血气分析与神经系统损害  

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新生儿科,湖南衡阳421001

出　　处：《小儿急救医学》2005年第6期467-469,共3页Pediatric Emergency Medicine

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。方法将55例新生儿分为3组:组1 pH>7.00,无神经系统异常,无需呼吸支持;组2 pH≤7.00,余同组1;组3,pH≤7.00,神经系统异常,需辅助呼吸支持。采集脐动脉血、产后1 h和2 h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各组间有显著差异;产后1h动脉血pH组1、3间和组2、3间有显著差异;产后1 h动脉血pH、PaCO2分别和脐动脉血pH、PaCO2比较,有显著差异;3组间有不同的神经系统表现;Apgar评分组3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同的神经系统后遗症。Objective To explore the relationship between the rapid changes in Pa CO2 and pH value and neurologic injury in. asphyxia infants in presence of severe academia. Methods Umbilical aterial blood and radial aterial blood at postnatal 1, 2 h were checked in 55 infants. These infants were divided into three groups： Ⅰ , pH〉 7.00, normal neurologic examination without respiratory support, Ⅱ, identification to Ⅰ except pHi7.00. Ⅲ, pHi7.00, abnormal neurologic examination with mechanical ventilation. Results Umbilical aterial blood pH was lower in Ⅲ vs and in Ⅱ vs Ⅰ, PaCO2 was higher in Ⅲ vs and in Ⅱ vs Ⅰ , At postnatal 1 h pH increased and PaCO2 decreased in all group, significant differences in three group remained. At postnatal 2 h, no differences were observed for pH and PaCO2 in Ⅱ and Ⅲ, there were different neurologic prognosis among groups, Apgar score was lower in Ⅲ. Conclusion After delivery pH and PaCO2 have rapid changes in presence of severe academia, lower pH and Apgar score with mechanical ventilation were poor prognosis factors of neurologic result.

关 键 词：围生期 窒息 新生儿 血气分析 神经系统损害 

分 类 号：R714.7[医药卫生—妇产科学]