脐动脉血气对新生儿窒息及预后判断的临床意义  

The significance of umbilical cord blood gas analysis in evaluating the prognosis of neonates

作　　者：秦山红[1] 马存丽[1] 罗佳[1] 马儒萍[1] 王兴梅[1] 

机构地区：[1]玉溪市人民医院妇产科,云南玉溪650030

出　　处：《云南医药》2014年第1期13-16,共4页Medicine and Pharmacy of Yunnan

摘　　要：目的探索脐动脉血气分析对新生儿窒息及预后判断的临床意义。方法新生儿出生后在其第一声啼哭前立即抽取脐动脉血0.1 ml测血气分析,同时对新生儿进行1 min、5 min、10 min的Apgar评分,记录羊水性状,并跟踪新生儿的临床预后。结果新生儿脐动脉血血气中,pH最低为6.585,pH<7.20者46例,新生儿窒息31例;重度窒息组、轻度窒息组和正常组比较,pH,PaCO2,HCO3-及BE的差异都有统计学意义(P<0.01),但PaO2的差异无统计学意义;在Apgar评分≤7分的窒息组31例中有10例pH<7.20,在Apgar评分>8分的正常组313例中有36例pH<7.20,2组比较差异有统计学意义(P<0.01)。在pH<7.20的46例患儿中有3例发生新生儿缺氧缺血性脑病(neonatal hypoxic-ischemic encephalopathy,HIE),pH≥7.20的298例患儿中有2例发生HIE,2组比较差异有统计学意义(P<0.01)。结论脐动脉血气分析有助于判明新生儿血气异常的性质及其严重程度,判断新生儿窒息应结合脐血血气、Apgar评分。Objective To explore the value of umbilical artery blood gas analysis in judging neonatal asphyxia and prognosis. Methods To extract 0.1 ml neonatal umbilical artery blood after delivery before crying.All neonatal umbilical artery blood gas analysis was measured immediately, at the time evaluating 1 min Apgar score, 5 min Apgar score, 10 min Apgar score and amniotic fluid situation.Results The value of the lowest pH was 6.585.In 46 neonates whose value of pH were below 7.2, there were 31 asphyxia neonates.As for the value of pH, PaCO2, HCO3- and BE, there were significant differences between the groups of asphyxia and the normal, but there was no significant differ- ences in PO2. There were 10 patients whose pH〈7.2 in the 31 new-born babies of Apgar score ≤7, there were 36 whose pH〈7.2 in the 313 new-bom babies of Apgar score 1≥8, there were significant differences between the groups of asphyxia and the normal. There were significant differences between the groups of fetal distress and no fetal dis- tress. There were 3 HIE in pH 〈7.2, and 2 HIE in pH ≥7.2,there were significant differences between the two groups.Conclusion There are correlativity and complement between Apgar score and umbilical artery blood gas analysis. Umbilical artery blood gas analysis is helpful for judging the nature and degree of fetal blood abnormal gas. Judging neonatal asphyxia should include umbilical artery blood gas analysis and Apgar score.

关 键 词：脐动脉 血气分析 新生儿窒息 预后 

分 类 号：R722[医药卫生—儿科]