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目的探讨胎心监护联合脐动脉血气分析及Apgar评分对羊水粪染窒息新生儿的预测价值。方法对585例羊水粪染新生儿进行分娩前胎心监护,出生后立即采集脐动脉血进行p H值测定,进行Apgar评分,分析3项指标与脏器损伤的关系,以及三者联合诊断羊水粪染新生儿窒息的灵敏度、特异度及符合率。结果 585例羊水粪染新生儿中共确诊窒息49例,占8.4%。随着p H值、Apgar评分的降低出现脏器损伤的新生儿比例升高(P<0.05),胎心监护异常组的脏器损伤发生率较正常组明显升高(P<0.05)。低Apgar评分(≤7分)联合异常胎心监护、脐动脉血p H值<7诊断羊水粪染新生儿窒息的敏感性为44.9%,特异性为100.0%,符合率为57.1%;低Apgar评分联合脐动脉血p H值<7.2、异常胎心监护诊断窒息的敏感性为83.7%,特异性为78.6%,符合率为82.5%。结论胎心监护联合脐动脉血气分析、Apgar评分可有效地预测评价羊水粪染新生儿窒息,为窒息新生儿及时采取正确的治疗措施提供了可靠的依据。
Objective To investigate the predictive value of fetal heart rate monitoring combined with umbilical arterial blood gas analysis and Apgar score in newborns with amniotic fluid meconium asphyxia. Methods 585 neonates with amniotic fluid stained with fetal amniotic fluid were enrolled in this study. Umbilical arterial blood was taken immediately after birth to determine p H value. Apgar score was used to analyze the relationship between the three indicators and the organ injury. The combined diagnosis of amniotic fluid Sensitivity, specificity and coincidence rate of fecal neonatal asphyxia. Results 585 neonates with amniotic fluid stained confirmed asphyxiation in 49 cases, accounting for 8.4%. With the p H value, Apgar score increased the proportion of neonates with organ injury increased (P <0.05), and the incidence of organ damage in abnormal fetal heart rate monitoring group was significantly higher than that of the normal group (P <0.05). Low Apgar score (≤7 points) combined with abnormal fetal heart monitoring, umbilical arterial blood p H value of <7 diagnosis of amniotic fluid fecal neonatal asphyxia sensitivity was 44.9%, specificity was 100.0%, the coincidence rate was 57.1%; low Apgar The score of combined umbilical arterial blood p H value <7.2, abnormal fetal heart rate monitoring of asphyxia sensitivity was 83.7%, specificity was 78.6%, the coincidence rate was 82.5%. Conclusion Fetal heart monitoring combined with umbilical arterial blood gas analysis, Apgar score can effectively predict asphyxiated amniotic fluid stained with neonatal asphyxia neonatal timely and appropriate treatment measures provide a reliable basis.