窒息新生儿动脉血乳酸、血糖的监测和观察  

Monitoring and observation of arterial blood lactate and blood sugar in newborn with asphyxia

作　　者：张晓婷 陈裕萍 彭娟丽 ZHANG Xiaoting;CHEN Yuping;PENG Juanli(Department of Neonatology,Fuyong People＇s Hospital,Shenzhen,Guangdong 518103,China)

机构地区：[1]广东省深圳市宝安区福永人民医院新生儿科,广东深圳518103

出　　处：《中国医学工程》2018年第7期16-20,共5页China Medical Engineering

基　　金：深圳市宝安区科技计划项目(2016CX297)

摘　　要：目的探究窒息新生儿血乳酸、血糖的变化及其对新生儿窒息程度和预后评估的临床价值。方法选取2015年1月‐2016年12月广东省深圳市宝安区福永人民医院新生儿科收治的窒息新生儿80例,依据阿氏评分(Apgar评分)标准分为轻度窒息组(52例)、重度窒息组(28例)。另取同期50例正常足月新生儿作为对照组。比较各组新生儿出生后1 h、3 h和24 h血乳酸、血糖情况;出生72 h根据新生儿危重病例评分(NCIS)分为非危重组(41例)、危重组(22例)、极危重组(17例)。比较各组新生儿血乳酸、血糖水平,并分析其与窒息预后的相关性。结果窒息组患儿血乳酸水平显著高于对照组,血糖水平显著低于对照组(P<0.05);与轻度窒息组相比重度窒息组患儿血乳酸升高、血糖降低更明显,差异有统计学意义(P<0.05)。NCIS评分危重组与极危重组患儿血乳酸水平显著高于非危重组,血糖水平显著低于对照组,差异有统计学意义(P<0.05);极危重组患儿血乳酸水平显著高于危重组,血糖水平显著低于危重组,差异有统计学意义(P<0.05);Spearman线性回归分析显示,NCIS评分与血乳酸呈显著负相关关系(r=-0.985,P<0.05),与血糖水平呈显著正相关关系(r=0.847,P<0.05)。线性回归方程为:Y乳酸=16.602-0.134X,Y血糖=24.324-0.223X;血乳酸水平越高、血糖水平越低,预后不良和死亡患儿比例越高,差异有统计学意义(P<0.05)。结论窒息新生儿动脉血乳酸升高、血糖水平降低,且窒息程度越重,异常越明显,血乳酸和血糖水平高的患儿预后不良,需要引起儿科临床医生的注意。【Objective】To explore the changes of blood lactic acid and blood sugar in newborn with asphyxia, and its degree of neonatal asphyxia and the clinical value of prognostic evaluation.【Methods】Eighty cases of newborn with asphyxia who accepted treatments in the Department of Neonatology in our hospital from January 2015 to December 2016 were selected, and were divided into the mild asphyxia group（52 cases） and the severe asphyxia group（28 cases） according to the Apgar scoring criteria. And other 50 cases of normal full-term neonates in the same period were selected as the control group. The blood lactate and blood sugar of newborn 1 h, 3 h and 24 h after birth between each group were compared; 72 h after birth, they were divided into noncritical group（41 cases）, critical group（22 cases） and extremely critical group（17 cases） according to the neonatal critical illness score（NCIS）. The blood lactic acid and blood sugar levels of the newborns were compared and their correlations with prognosis of asphyxia were analyzed.【Results】The blood lactic acid level in the asphyxia group was significantly higher than that in the control group, and the blood glucose level was significantly lower than that of the control group（P〈0.05）; compared with the mild asphyxia group, in the severe asphyxia group, the blood lactate were increased and blood sugar were decreased more obviously, and the difference was statistically significant（P〈0.05）. In the NCIS score critical group and extremely critical group, the blood lactate level was significantly higher than that in the non-critical group, and the level of blood sugar was significantly lower than that in the control group, the differences were statistically significant（P〈0.05）; the blood lactate level was significantly higher, the blood glucose level was significantly lower in the extremely critical group than that in the critical group, and the difference was statistically significant（P〈0.05）; Spearman linear regression analys

关 键 词：窒息新生儿 乳酸 血糖 预后 窒息程度 

分 类 号：R722.1[医药卫生—儿科]