胎儿窘迫与脐静脉血pH、PCO_2、PO_2、HCO_3和新生儿Apgar评分间的关系  

Relationship Between Fetal Distress and Neonatal Apgar Score and Umbilical Vein Blood pH,PCO_2,PO_2 and HCO_3^-

作　　者：牛秀敏[1] 马好[1] 辛玉英[1] 施洪芬 

机构地区：[1]天津医学院附属医院妇产科 [2]天津医学院附属医院血气室

出　　处：《天津医药》1991年第3期144-146,共3页Tianjin Medical Journal

摘　　要：本文测定临床诊断胎儿窘迫48例及正常45例新生儿的脐静脉血气值及新生儿Apgar 评分,并将两组进行比较。结果:正常组 pH 均值7.34、PCO_2 39.17、PO_2 28.48、HCO_(?)22.85;胎儿窘迫组 pH 7.27、PCO_2 47.57、PO_2 20.16、HCO_3^-20.04(P 均<0.01)。93例新生儿中1分钟 Apgar 评分≥8者共69例,其中59例 pH≥7.27,24例1分钟 Apgar 评分<8者中有10例的 pH<7.27。5分钟 Apgar 评份<8者仅10例,其中7例 pH<7.27。27例电子胎心监护异常,其中 pH<7.27,Apgar 评分<8者仅2例。一般认为估价胎儿窘迫及新生儿窒息要综合临床诊断,电子胎心监护、羊水情况、胎心音听诊,脐静脉血气分析及 Apgar 评分等方法才能正确判断。Immediate determinations of neonatal umbilical vein blood pH,PCO_2,PO_2,HCO_3^-,and Apgar scores were done in 93 cases(63 cesarean section,9 low forceps,16 spontaneous deliveries).The results revealed that in the normal group(n=45)the mean values were pH 7.34, PCO_2 39.17,PO_2 28.48 and HCO_3^- 22.85;in the fetaldistress group(n=48)pH 7.27,PCO_2 47.57,PO_2 20.16,and HCO_3^- 20.04,(P<0.001).Of the 93 neonates,69 had 1-minute Apgar scores≥8 and 59 of them had pH≥7.27,24 had 1-minute Apgar scores<8 and 10 had pH 7.27.At the 5-minute scoring only10 were<8,with 7 of the 10 having pH<7.27.Fetal heart rate monitoring in 27 wereconsidered abnormal,only 2 had pH<7.27 and Apgar scores<8.It was suggestedthat combined analysis of the clinical data,electronic fetal heart rate recordingumbilical vein blood gas analysis and Apgar score was essential in proper diagnosisandassessment of fetal distress and neonatal asphyxia.

关 键 词：胎儿窘迫 APGAR评分 新生儿窒息 

分 类 号：R714.430.2[医药卫生—妇产科学]