胎儿血氧饱和度监测对新生儿窒息和酸血症的诊断价值  

Effectiveness of Application of Intrapartum FSO_2 Monitoring in Diagnosis of the Neonatal Asphyxia and Acidemias

作　　者：郭翠梅[1] 吴连方[1] 刘晓巍[1] 

机构地区：[1]首都医科大学附属北京妇产医院产科,北京100026

出　　处：《中国医疗设备》2015年第3期101-104,共4页China Medical Devices

基　　金：首都卫生发展科研专项项目资助(2011-2011-01)

摘　　要：目的探讨胎儿血氧饱和度监测对于新生儿窒息和酸血症的诊断价值。方法对98例在产程中出现可疑胎心监护异常或羊水粪染的产妇进行电子胎心监护和胎儿血氧饱和度测定,并对新生儿进行Apgar评分及脐动脉血血气分析。结果胎儿血氧饱和度与新生儿脐动脉血的p H值有显著相关性(r=0.582),与脐动脉碱剩余(BE)的相关性为0.302;与脐动脉二氧化碳分压(PCO2)的相关性为-0.379,与脐动脉血氧分压(PO2)的相关性为0.367,与脐动脉血氧饱和度(Sa O2)的相关性为0.457。轻度窒息新生儿的血氧饱和度显著低于非窒息新生儿的血氧饱和度,差异具有统计学意义(P<0.001)。胎儿血氧饱和度对新生儿酸血症的敏感性为70.00%,特异性为98.86%,阳性预测值为87.50%,阴性预测值为96.67%,准确率为95.92%。结论胎儿血氧饱和度可有效反映胎儿的宫内状况,以辅助临床诊断新生儿窒息和酸血症。胎心监护结合血氧饱和度监测可能是一种能够很好地对产程中胎儿进行监测的手段,但是其安全性及有效性还需进一步探讨。Objective To explore the effectiveness of application of intrapartum FSO2（Fetal Oxygen Saturation） monitoring in predicting neonatal asphyxia and acidosis.Methods Electronic FHR（Fetal Heart Rate） and FSO2 monitoring were performed respectively in 98 women who had suspected abnormal FHR or MSAF（Meconium-Stained Amniotic Fluid） in the delivery.Additionally,the Apgar score was accessed for each newborn and the umbilical artery blood flow was also measured.Results The FSO2 showed significant correlation（r=0.582） with the p H value of umbilical artery blood; while its correlation with umbilical artery BE（Base Excess）,PCO2（Partial Pressure of Carbon Dioxide）,PO2（Partial Pressure of Oxygen） and Sa O2（Arterial Oxygen Saturation） was 0.302,-0.379,0.367 and 0.457 respectively.The oxygen saturation of newborns with minor neonatal asphyxia was remarkably lower than that of newborns without neonatal asphyxia,which was of statistical significance（P〈0.001）.The sensitivity,specificity,positive and negative predictive values as well as the accuracy of Sa O2 in predicting fetal acidosis were 70.00%,98.86%,87.50%,96.67% and 95.92%.Conclusion FSO2 monitoring proved its effectiveness in reflecting the fetal intrauterine conditions,which can be applied to assist the diagnosis of fetal asphyxia and acidosis.Combined use of electronic FHR and FSO2 monitoring may be taken as a good method for fetal monitoring in the delivery,but further discussion was needed to verify its security and effectiveness.

关 键 词：胎儿血氧饱和度 电子胎心监护 新生儿窒息 新生儿酸血症 

分 类 号：R714.5[医药卫生—妇产科学]