残余羊水、脐动脉血乳酸水平监测对未足月胎膜早破孕妇妊娠结局和新生儿预后的影响  

Influence of Residual Amniotic Fluid Index and Umbilical Artery Blood Lactic Acid Levels on Pregnant Women and Newborn Outcome in Premature Rupture of Membranes

作　　者：曾麟 杨昱 

机构地区：[1]广东省连州市连州镇中心医院,广东连州513400 [2]广东省清远市妇幼保健院

出　　处：《中国医学创新》2014年第33期18-20,共3页Medical Innovation of China

基　　金：国家自然科学基金资助项目(81060165)

摘　　要：目的:探讨残余羊水(AFI)、脐动脉血乳酸(UABLA)水平监测对未足月胎膜早破(PPROM)孕妇妊娠结局和新生儿预后的影响。方法:回顾性分析2009年2月-2013年12月本院及清远市妇幼保健院妇产科收治的457例PPROM的临床资料,根据AFI和UABLA浓度分为四组,A组(AFI≤40 mm,UABLA≤4 mmol/L,n=124),B组(AFI≤40 mm,UABLA>4 mmol/L,n=114),C组(80 mm>AFI>40 mm,UABLA≤4 mmol/L,n=108),D组(80 mm>AFI>40 mm,UABLA>4 mmol/L,n=111),比较四组的妊娠结局和新生儿预后情况。结果:A组和B组的破膜至分娩时间均短于C组和D组(P<0.05);A组和B组病死率高于C和D组(P<0.05);A组和C组Apgar评分高于B和D组(P<0.05);Logistic回归分析显示AFI≤40 mm是新生儿死亡发生的独立危险因素(P<0.05),UABLA>4 mmol/L是导致新生儿重度窒息发生的独立危险因素(P<0.05)。结论:PPROM后AFI与UABLA水平对妊娠结果和新生儿预后具有一定的评估价值,密切监测AFI、UABLA水平可提高分娩安全性和降低新生儿病死率。Objective：To discuss the influence of residual amniotic fluid index AFI and UABLA levels on pregnant women and newborns outcome in PPROM.Method：457 pregnant women with PPROM were selected and divided into four groups according to AFI and UABLA levels from February 2009 to December 2013 in our hospital,the four groups were the group A（AFI ≤ 40 mm,UABLA ≤ 4 mmol/L,n=124）,the goup B（AFI ≤ 40 mm,UABLA〉4 mmol/L,n=114）,the group C（80 mmAFI〉40 mm,UABLA ≤ 4 mmol/L,n=108）,the group D（80 mm〉AFI〉40 mm,UABLA〉4 mmol/L,n=111）.Pregnant women and newborn outcome of the four groups were compared.Result：The interval between rupture of membranes and delivery in the group A,B were significantly shorter than that in the group C,D（P〈0.05）.The case of fatality rate of newborns in the group A,B were significantly higher than the group C,D（P〈0.05）.Logistic regression analysis showed that AFI ≤ 40 mm was independent risk factors for neonatal mortality（P〈0.05）,and that UABLA4 mmol/L was independent risk factors for neonatal asphyxia（P〈0.05）.Conclusion：After PPROM detecting the AFI and UABLA levels for pregnancy outcomes and neonatal outcomes assessment has a certain value,close monitoring of residual amniotic fluid, UABLA levels can improve the safety in dilivery and reduce the neonatal childbirth fatality.

关 键 词：残余羊水 脐动脉血乳酸 妊娠结果 预后 

分 类 号：R714.433[医药卫生—妇产科学]