新生儿窒息后血乳酸和动脉血气变化对评估器官损害程度的临床价值  

Clinical Value of Changes of Blood Lactic Acid and Arterial Blood Gas in Evaluating the Degree of Organ Damage after Neonatal Asphyxia

作　　者：罗海平 陈泽林 温晓萍 陈靖 王小丽 张鹏程 龚艳红 黄晓红 张冰 覃肇源 LUO Haiping;CHEN Zelin;WEN Xiaoping;CHEN Jing;WANG Xiaoli;ZHANG Pengcheng;GONG Yanhong;HUANG Xiaohong;ZHANG Bing;QIN Zhaoyuan(Huizhou Zhongda Huiya Hospital,Huizhou 516081,China)

机构地区：[1]惠州市中大惠亚医院,广东惠州516081

出　　处：《中外医学研究》2020年第7期66-68,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究新生儿窒息后血乳酸和动脉血气变化在器官损害程度及疾病预后评价中的应用价值。方法:将2013年1月-2019年10月笔者所在医院的新生儿窒息患儿183例纳入研究组,以1 min新生儿Apgar评分为标准进行分组,重度窒息组39例,轻度窒息组144例;以器官损伤程度进行分组,单器官损伤组141例,多器官损伤组42例。选取同期健康新生儿100例纳入对照组。对比各组血乳酸、动脉血气指标水平及1 min新生儿Apgar评分,对血乳酸与BE水平、血pH值及1 min新生儿Apgar评分的相关性进行分析。结果:轻度窒息组、重度窒息组血乳酸水平均高于对照组,且重度窒息组血乳酸水平高于轻度窒息组(P<0.05);轻度窒息组、重度窒息组BE水平、血pH值、1 min新生儿Apgar评分均低于对照组,且重度窒息组均低于轻度窒息组(P<0.05);单器官损伤组血乳酸水平低于多器官损伤组,BE水平、血pH值、1 min新生儿Apgar评分均高于多器官损伤组(P<0.05);血乳酸与BE水平、血pH值、1 min新生儿Apgar评分呈负相关(P<0.05)。结论:血乳酸及动脉血气指标是客观、灵敏、简易的量化指标,能够在新生儿窒息患儿临床诊疗中对病情严重程度及疾病预后给予有效指导,临床应用价值较高。Objective:To explore the application value of changes of blood lactic acid and arterial blood gas in evaluating the degree of organ damage and prognosis after neonatal asphyxia.Method:A total of 183 children with neonatal asphyxia in our hospital from January 2013 to October 2019 were selected as the study group,and the neonatal Apgar score at 1 min was used as the standard for grouping,39 cases in the severe asphyxia group and 144 cases in the mild asphyxia group.And according to the degree of organ damage,children in the study group were divided into the single organ damage group 141 cases and the multiple organ damage group 42 cases.And a total of 100 healthy neonates were selected as the control group at the same time.The levels of blood lactic acid and arterial blood gas indexes and neonatal Apgar score at 1 min were compared in each group.The correlations of blood lactic acid with BE level,blood pH value and neonatal Apgar score at 1 min were analyzed.Result:The levels of blood lactic acid in the mild asphyxia group and the severe asphyxia group were higher than those of the control group,and the level of blood lactic acid in the severe asphyxia group was higher than that of the mild asphyxia group(P<0.05).The BE levels,blood pH values and neonatal Apgar scores at 1 min in the mild asphyxia group and the severe asphyxia group were lower than those of the control group,and the severe asphyxia group were lower than those of the mild asphyxia group(P<0.05).The level of blood lactic acid in the single organ damage group was lower than that of the multiple organ damage group,and BE level,blood pH value and neonatal Apgar score at 1 min were higher than those of the multiple organ damage group(P<0.05).Blood lactic acid was negatively correlated with BE level,blood pH value and neonatal Apgar score at 1 min(P<0.05).Conclusion:The indexes of blood lactic acid and arterial blood gas are objective,sensitive and simple quantitative indexes.They can effectively guide the severity and prognosis of neonatal asphyxia in c

关 键 词：新生儿窒息 血乳酸 动脉血气 器官损害 

分 类 号：R722.12[医药卫生—儿科]