新生儿脐带血血气分析对三种分娩方式的评价  

Analysis and evaluation of the three kinds of delivery methods of umbilical cord blood gas analysis

作　　者：陈景亮[1] 杨智君[1] 乔淼[1] 杜立宏[1] 

机构地区：[1]辽宁省鞍山市中心医院麻醉科,辽宁鞍山114001

出　　处：《中国医刊》2016年第3期59-62,共4页Chinese Journal of Medicine

摘　　要：目的通过新生儿脐带血血气分析,对顺产、硬膜外患者自控镇痛(patient controlled epidural analgesia,PECA)顺产和剖宫产三种分娩方式进行评价。方法将即将分娩的产妇根据临床查体及产妇意愿分成A(顺产)、B(PECA顺产)、C(剖宫产)三组。胎儿娩出后抽取脐带动脉血进行血气分析,比较氢离子浓度指数(hydrogenion concentratio,p H)、氧分压(partial pressure of oxygen,PO_2)、二氧化碳分压(partial pressure of carbon dioxide,PCO_2)、乳酸值(lactate,Lac)、缓冲碱(buffer base,BB),碱剩余(buffuer excess,BE)及碳酸氢盐(hydrogencarbonate,HCO_3^-)。结果 A组比B组和C组p H、PO_2、BE均降低(P<0.05);PCO_2、Lac、BB及均升高(P<0.05);差异存在显著性。B组和C组之间p H、PO_2、BE、BB、PCO_2、Lac、HCO_3^-差异均无显著性(P>0.05)。结论 PECA顺产和剖宫产能降低胎儿缺氧和酸中毒的风险,但是由于剖宫产母婴并发症严重,采取PECA顺产,对新生儿更安全,建议推广使用。Objective To analyze neonatal umbilical cord blood,blood gas analysis and evaluation of vaginal delivery,vaginal delivery and cesarean section PECA three delivery way.Method Will be the delivery according to the clinical examination and maternal intention into A,B,C three groups,group A（birth）,group B（PECA birth） and group C（cesarean section）.Blood gas analysis of umbilical cord blood after delivery of fetus,compare the hydrogenion concentration index（p H）,oxygen partial pressure（PO2）,partial pressure of carbon dioxide（PCO2）,lactate（Lac）,buffer base（BB）,base excess（BE） and sodium bicarbonate（HCO3^-）.Result A group than B group and C group p H and PO2 increased（P〈0.05）;PCO2,Lac,BB and BE decreased（P〈0.05）;there were significant differences.There was no significant difference in p H,PO2,BE,BB,PCO2,Lac,HCO3^-between B and C groups（P〉0.05）.Conclusion PECA vaginal delivery and cesarean section reduces the risk of fetal hypoxia and acidosis,but because of serious complications of cesarean section,and there are other risk of neonatal complications,we consider PECA birth,safer for newborns,should promote the use of.

关 键 词：脐带血 血气分析 硬膜外患者自控镇痛 剖宫产 

分 类 号：R714.7[医药卫生—妇产科学]