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目的分析脐带绕颈对脐血血气的影响,探讨脐带绕颈经阴道分娩的可行性。方法选择206例足月、单胎、头位经阴道分娩的新生儿(有脐带绕颈104例,无脐带绕颈102例),胎儿娩出后即行脐动脉穿刺进行脐血血气分析。结果有与无脐带绕颈组各脐血血气分析值比较,差异无显著性意义(均P>0.05);在脐带绕颈组中有羊水污染者(39例)与无羊水污染者(65例)间pH、PCO2、HCO3-、BE比较,差异有显著性意义(均P<0.01),而PO2、SaO2差异无显著性意义(均P>0.05)。结论脐带绕颈不一定造成胎儿的酸中毒,可经阴道分娩,但在合并有羊水污染时宜尽早结束分娩。
Objective To analyze the influence of umbilical cord around the neck on the blood of cord blood and explore the feasibility of vaginal delivery around the neck. Methods A total of 206 neonates with full-term, single and head-vaginal delivery were enrolled in this study. There were 104 cases of umbilical cord around the neck and 102 cases of umbilical cord around the neck. Umbilical artery puncture was performed to analyze the blood gases of the umbilical cord. There was no significant difference between the two groups (all P> 0.05). In the umbilical cord around the neck group, there were 39 cases of amniotic fluid contamination and 65 cases of non-amniotic fluid contamination (P <0.01). There was no significant difference between PO2 and SaO2 (P> 0.05). There was no significant difference in pH, PCO2, HCO3- and BE between the two groups. Conclusion The umbilical cord around the neck may not cause fetal acidosis, vaginal delivery may be, but when combined with amniotic fluid pollution should be the end of delivery as soon as possible.