论文部分内容阅读
目的探讨生后早期外周动脉血气分析对于新生儿窒息病情评判的临床价值。方法选取2012年3月至2013年4月本院新生儿科收治的足月窒息新生儿为观察组,其中1 min Apgar评分4~7者为轻度窒息组,≤3分者为重度窒息组,同期随机选取无窒息的足月新生儿为对照组,各组新生儿均在生后1 h内取右手桡动脉血进行血气分析并比较。将窒息组按外周动脉血气pH值分为>7.25、7.0~7.25、<7.0三组,比较各组发生脏器功能受损的比例。结果轻度窒息组98例,重度窒息组24例,对照组86例。各组新生儿性别、胎龄、出生体重、分娩方式、取血时间等差异均无统计学意义(P>0.05)。对照组pH值和BE值均高于轻、重度窒息组[pH:(7.38±0.06)比(7.16±0.08)、(7.10±0.09),BE:(-4.1±0.5)mmol/L比(-11.1±4.6)mmol/L、(-14.4±2.6)mmol/L,P<0.05],轻、重度窒息组之间差异无统计学意义(P>0.05)。窒息组患儿中,外周动脉血气pH值>7.25组、7.0~7.25组和<7.0组发生脏器功能受损的比例分别为53.3%、88.9%、100%,差异有统计学意义(P<0.05)。结论 Apgar评分的轻重程度不能完全代表窒息的程度,生后1 h内外周动脉血气分析检测是弥补其不足的一项客观指标。
Objective To investigate the clinical value of early postnatal peripheral arterial blood gas analysis in the evaluation of neonatal asphyxia. Methods From March 2012 to April 2013, infants with full-term asphyxia admitted to our neonatology department of our hospital were selected as the observation group. Among them, 1 to 7 min Apgar score was mild asphyxia group, and ≤ 3 score was severe asphyxia group, Randomly selected asphyxiated full-term newborns at the same period as the control group, each group of newborns within 1 h after birth within the right hand radial artery blood gas analysis and comparison. The asphyxia group was divided into three groups according to the pH value of peripheral arterial blood gas> 7.25,7.0 ~ 7.25, <7.0. The proportions of organ dysfunction in each group were compared. Results 98 cases of mild asphyxia group, 24 cases of severe asphyxia group, control group of 86 cases. Neonatal gender, gestational age, birth weight, modes of delivery, blood sampling time and other differences were not statistically significant (P> 0.05). The pH value and BE value in the control group were significantly higher than those in the mild to severe asphyxia group [pH: (7.38 ± 0.06) vs (7.1 ± 0.08), (7.10 ± 0.09), BE: (-4.1 ± 0.5) mmol / L 11.1 ± 4.6 mmol / L, 14.4 ± 2.6 mmol / L, P <0.05]. There was no significant difference between mild and severe asphyxia groups (P> 0.05). Asphyxia group, the peripheral arterial blood gas pH> 7.25 group, 7.0 ~ 7.25 group and <7.0 group were visceral dysfunction were 53.3%, 88.9%, 100%, respectively, the difference was statistically significant (P < 0.05). Conclusion Apgar score severity can not completely represent the degree of asphyxia, 1 h after birth, peripheral arterial blood gas analysis is an objective measure to make up for its deficiencies.