摘要
目的探讨脐血血气分析联合出生1h桡动脉血血气分析对缺氧新生儿近期器官损害及远期预后的评估价值。方法选取中山大学附属第一医院新生儿科2004年10月-2006年11月住院的541例新生儿为研究对象,对其脐动脉血及生后1h桡动脉血行血气分析,依据pH值分为脐血pH<7.2、出生1h桡动脉血pH<7.3组(组1);脐血pH≥7.2、出生1h桡动脐血pH<7.3(组2);脉血pH<7.2、出生1h桡动脉血pH≥7.3组(组3);脐血pH≥7.2、出生1h桡动脉血pH≥7.3组(组4)。观察住院期间各组缺氧造成各器官损害的表现。对其中158例新生儿进行专科随访,54例在1～2岁进行婴幼儿智能测验量表(CDCC)评分,得出智力发育指数(MDI)和运动发育指数(PDI)。采用SPSS13.0软件进行统计学分析。结果近期器官损害发生率在组1、组2、组3、组4间差异具有统计学意义(Pa<0.01),远期运动发育异常发生率在组1、组2、组3、组4间差异具有统计学意义(Pa<0.05)。体格及智力发育异常发生率在组1、组2、组3、组4差异无统计学意义。组1发生器官损害的种类最多(χ2=78.348P<0.01),远期运动发育异常发生率亦最高。结论脐血pH<7.2且出生1h动脉血pH<7.3可预测多器官损害的发生,且有助于预测远期运动发育异常。出生时存在缺氧、酸中毒的新生儿应监测生后血气变化。
Objective To explore the value of umbilical cord combined with radial arterial blood gas analysis at 1 hour after birth in evaluating the short - term and long - term prognosis of neonates with anoxia. Methods Five hundred and forty - one newborn infants admitted to our hospital from Oct. 2004 to Nov. 2006 were studied. Blood gas analysis of umbilical artery at birth and radial artery at 1 hour after birth were performed. According to the pH,they were divided into 4 groups： Umbilical arterial pH 〈 7.2 and radial arterial pH 〈 7.3 group（ group 1 ） ;umbilical arterial pH ≥7.2 and radial arterial pH 〈 7.3 group （group 2） ;umbilical arterial pH 〈 7.2 and radial arterial pH ≥ 7.3 group （ group 3 ） ; umbilical arterial pH ≥ 7.2 and radial urterial pH 97.3 group （ group 4）. One hundren and fifty - eight cases were followed up to evaluate their long - term development. By the scale of Child Development Center of China （CDCC） ,mental development index （MDI） and psychomotor development index （PDI） were checked in some cases of 1 - 2 years old. The results were analyzed by SPSS 13.0 software. Resuits Among group 1, group 2, group 3 and group 4, differences of organs dysfunction incidence had statistical significance （ Pa 〈 0.01 ） , and difference of long - term motor development abnormality had statistical significance （ P 〈 0.05 ）, but, difference of physical and intellectual development abnormality had no statistical significance. The children in group 1 had the most varieties of organs dysfunction （x^2 = 78. 348 P 〈 0.01 ）, and the highest incidence of motor development abnormality. Conclusions Combination of umbilical and arterial blood gas analysis may be predictive of multiple organs dysfunction. A low pH value of umbilical artery at birth and persistence or deterioration of pH after birth may be predictive of long - term motor development abnormality. Blood gas measurement shall be monitored if hypoxia and acidosis are identified.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第2期129-131,共3页
Journal of Applied Clinical Pediatrics
关键词
脐血
血气分析
缺氧
预后
婴儿
新生
umbilical cord
blood gas analysis
anoxia
prognosis
infant, newborn
