胎心监护减速面积联合脐血血气对新生儿预后的预测价值  

Predictive value of fetal heart rate monitoring deceleration area combining with umbilical cord blood gas on neonatal prognosis

作　　者：靳元元 李铭德 刘洋[2] 张建军[2] JIN Yuanyuan;LI Mingde;LIU Yang;ZHANG Jianjun(School of Clinical Medicine,Weifang Medical University,Weifang,Shandong 261053,China;Second Department of Obstetrics,Affiliated Hospital of Weifang Medical University,Weifang,Shandong 261000,China)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261000 [2]潍坊医学院附属医院产二科,山东潍坊261000

出　　处：《中国优生与遗传杂志》2022年第10期1812-1817,共6页Chinese Journal of Birth Health & Heredity

基　　金：潍坊市科技发展计划项目(医学类)(2019YX058)。

摘　　要：目的 比较不同减速类型的新生儿脐动脉血气的差异;比较产时胎心监护单位时间减速区面积与脐动脉血气对于新生儿预后的预测价值。方法 以2019年12月至2021年10月于潍坊医学院附属医院产科经阴道分娩的产妇及新生儿为研究对象,其中Ⅰ类胎心监护为对照组共40例,间歇性变异减速组40例,反复性变异减速组40例,晚期减速组40例,比较不同减速类型的新生儿脐动脉血气值的差异;比较单位时间减速区面积、脐动脉血pH、乳酸及其联合对于新生儿脏器功能损伤的预测价值。结果 三类减速组脐动脉血pH、PO_(2)均低于对照组,乳酸、PCO_(2)均高于对照组,呈现缺氧、酸中毒状态;单位时间减速区面积与脐动脉血pH呈显著负相关,与乳酸呈显著正相关;脐动脉血气值对于新生儿脏器功能损伤的预测价值要优于单位时间减速区面积,而将两者结合预测价值要优于单一指标,具有较高的敏感性和特异性。结论 将产时胎心监护单位时间减速区面积与脐血血气分析联合可以提高对新生儿脏器功能损伤的预测价值。Objective To compare the differences of umbilical arterial blood gas in newborns with different deceleration types. To compare the predictive value of fetal heart rate monitoring unit time deceleration area and umbilical arterial blood gas for neonatal prognosis. Methods Taking the pregnant women and newborns who delivered vaginally in the obstetrics department of the Affiliated Hospital of Weifang Medical University from December 2019 to October 2021 as the research objects, 40 cases were randomly selected as the control group, 40 cases were selected as the intermittent variable deceleration group, 40 cases were selected as the repeated variable deceleration group, 40 cases were selected as the late deceleration group.Comparing the differences of umbilical arterial blood gas between each group. Analyzing the correlation between the fetal heart rate monitoring unit time deceleration zone area and umbilical arterial blood pH and lactic acid. Comparing the predictive value of unit time deceleration zone area, umbilical arterial blood pH, lactic acid and their combination for neonatal organ dysfunction. Results The pH and PO_(2) of umbilical arterial blood in the three kinds of deceleration group were lower than those in the control group, and the lactic acid and PCO_(2) were higher than those in the control group, showing a state of acidosis and anoxia. The area of deceleration zone in unit time was significantly negatively correlated with umbilical arterial blood pH and positively correlated with lactic acid. The predictive value for neonatal organ dysfunction of umbilical arterial blood gas is better than the area of deceleration zone in unit time, and the combination of the them is better than a single index, which has high sensitivity and specificity. Conclusion Combining the area of fetal heart rate monitoring deceleration zone in unit time with cord blood gas analysis can improve the predictive value of neonatal organ dysfunction.

关 键 词：胎心监护 减速区面积 脐动脉血气 新生儿窒息 

分 类 号：R722.1[医药卫生—儿科]