中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
23期
50-52
,共3页
秦山红%马存丽%马儒萍%罗佳%王兴梅
秦山紅%馬存麗%馬儒萍%囉佳%王興梅
진산홍%마존려%마유평%라가%왕흥매
脐动脉%血气%窒息%新生儿%预后
臍動脈%血氣%窒息%新生兒%預後
제동맥%혈기%질식%신생인%예후
Umbilical artery%Blood gas%Asphyxia%Neonate%Prognosis
目的 探讨脐血血气分析与Apgar评分的相关性及脐血血气分析对新生儿预后的评估价值.方法 检测541名新生儿的脐动脉血及生后1h桡动脉血的血气分析;同时收集相关临床资料(如胎龄、体质量、母婴病理情况、家族史、疾病的发生发展等情况),结合临床检验、检查,观察住院期间有无缺氧造成各器官损害的表现.结果 本研究脐动脉血血气分析参数平均值为:酸碱度(pH值)7.21±0.10,二氧化碳分压(PCO2)(59±14) mm Hg(1 mm Hg=0.133 kPa),氧分压(PO2)(14±8) mm Hg,碳酸氢根(HCO3-)(23.7±2.9)mmol/L,剩余碱(BE)(-4.1±3.8)mmol/L,氧饱和度(SpO2)(15.0±14.6)％.有胎儿宫内窘迫、异常分娩史的新生儿脐血pH值较低,早产儿脐血pH值较足月儿高.1 min Apgar评分与脐血pH值及其他血气指标均有明显相关性,而5 min Apgar评分仅与脐动脉血PO2和SpO2相关.神经系统损害与脐血血气分析各指标均有相关性,肾、心、代谢方面的损害与脐血pH及PCO2值相关,肺、消化、血液系统损害只与脐血pH值相关.联合脐血pH值＜7.20及Apgar评分≤7评估器官损害的发生率较单用其中一项指标高.结论 脐血血气分析与1 min Apgar评分有明显相关性,脐血血气分析及Apgar评分对窒息相关的器官损害均具有诊断价值,但其敏感性及特异性不理想.综合脐血pH值及Apgar评分可以提高窒息相关器官损害的预测价值.
目的 探討臍血血氣分析與Apgar評分的相關性及臍血血氣分析對新生兒預後的評估價值.方法 檢測541名新生兒的臍動脈血及生後1h橈動脈血的血氣分析;同時收集相關臨床資料(如胎齡、體質量、母嬰病理情況、傢族史、疾病的髮生髮展等情況),結閤臨床檢驗、檢查,觀察住院期間有無缺氧造成各器官損害的錶現.結果 本研究臍動脈血血氣分析參數平均值為:痠堿度(pH值)7.21±0.10,二氧化碳分壓(PCO2)(59±14) mm Hg(1 mm Hg=0.133 kPa),氧分壓(PO2)(14±8) mm Hg,碳痠氫根(HCO3-)(23.7±2.9)mmol/L,剩餘堿(BE)(-4.1±3.8)mmol/L,氧飽和度(SpO2)(15.0±14.6)％.有胎兒宮內窘迫、異常分娩史的新生兒臍血pH值較低,早產兒臍血pH值較足月兒高.1 min Apgar評分與臍血pH值及其他血氣指標均有明顯相關性,而5 min Apgar評分僅與臍動脈血PO2和SpO2相關.神經繫統損害與臍血血氣分析各指標均有相關性,腎、心、代謝方麵的損害與臍血pH及PCO2值相關,肺、消化、血液繫統損害隻與臍血pH值相關.聯閤臍血pH值＜7.20及Apgar評分≤7評估器官損害的髮生率較單用其中一項指標高.結論 臍血血氣分析與1 min Apgar評分有明顯相關性,臍血血氣分析及Apgar評分對窒息相關的器官損害均具有診斷價值,但其敏感性及特異性不理想.綜閤臍血pH值及Apgar評分可以提高窒息相關器官損害的預測價值.
목적 탐토제혈혈기분석여Apgar평분적상관성급제혈혈기분석대신생인예후적평고개치.방법 검측541명신생인적제동맥혈급생후1h뇨동맥혈적혈기분석;동시수집상관림상자료(여태령、체질량、모영병리정황、가족사、질병적발생발전등정황),결합림상검험、검사,관찰주원기간유무결양조성각기관손해적표현.결과 본연구제동맥혈혈기분석삼수평균치위:산감도(pH치)7.21±0.10,이양화탄분압(PCO2)(59±14) mm Hg(1 mm Hg=0.133 kPa),양분압(PO2)(14±8) mm Hg,탄산경근(HCO3-)(23.7±2.9)mmol/L,잉여감(BE)(-4.1±3.8)mmol/L,양포화도(SpO2)(15.0±14.6)％.유태인궁내군박、이상분면사적신생인제혈pH치교저,조산인제혈pH치교족월인고.1 min Apgar평분여제혈pH치급기타혈기지표균유명현상관성,이5 min Apgar평분부여제동맥혈PO2화SpO2상관.신경계통손해여제혈혈기분석각지표균유상관성,신、심、대사방면적손해여제혈pH급PCO2치상관,폐、소화、혈액계통손해지여제혈pH치상관.연합제혈pH치＜7.20급Apgar평분≤7평고기관손해적발생솔교단용기중일항지표고.결론 제혈혈기분석여1 min Apgar평분유명현상관성,제혈혈기분석급Apgar평분대질식상관적기관손해균구유진단개치,단기민감성급특이성불이상.종합제혈pH치급Apgar평분가이제고질식상관기관손해적예측개치.
Objective To investigate the value of umbilical artery blood gas analysis on judging neonatal asphyxia and prognosis.Methods Four hundred and fifty-one newborn infants from October 2009 to November 2011 were chose.Blood gas analysis of umbilical artery at birth and radial artery at 1 hour after birth were accessed in all 541 cases ; The arterial blood gas was rechecked if necessary.Clinical data including the gestational age,birth weight,maternal and neonatal conditions,family history,information of occurrence and development of diseases were recorded.The clinical manifestation and laboratory examination to determine the organ dysfunction due to pefinatal asphyxia was observed.Results The reference value of umbilical arterial blood gas analysis:pH 7.21 ± 0.10,PCO2 (59 ± 13)mm Hg(1 mm Hg =0.133 kPa),PO2(14 ±8)mm Hg,HCO3-(23.7 ±2.9) mmol/L,BE(-4.1 ± 3.8)mmoL/L,SO2(15.0 ± 14.6)％.Correlation analysis of high risk factors and umbilical arterial pH indicated that neonates with fetal distress and perverse labor had a significantly lower pH value; preterm infants had a significantly higher pH value.Significant correlation was found between Apgar score at 1 minute after birth and all the parameters of umbilical arterial blood gas.No correlation was found between Apgar score at 5 minute after birth and the parameters of umbilical arterial blood gas except PO2 and SO2.The analytic result indicated that there was correlation between nervous system impairment and all parameters of umbilical arterial blood gas.Impairment of kidney,heart and metabolism was correlated with umbilical arterial pH and PCO2 value.Impairment of lung,digestion and hematological system was only correlated with umbilical arterial pH value.Conclusions There was significant correlation between Apgar score at 1 minute after birth and the umbilical cord blood gas analysis.Both umbilical cord blood gas analysis and Apgar score have diagnostic value in assessing asphyxia-related organs dysfunction,but the sensitivity and specificity were unsatisfied.Combination of umbilical arterial pH value and Apgar score may elevate the predictive value.
