摘要
目的分析新生窒息患儿血气指标变化与患儿窒息程度及预后的相关性。方法选取68例新生儿窒息患儿作为观察组,另选取同时期收治的排除新生儿窒息的46例新生儿作为对照组。观察两组新生儿血气指标[pH、二氧化碳分压(PaCO_2)、氧分压(PaO_2)、碳酸氢根(HCO_3^-)、血乳酸(Lac)及剩余碱(BE)],分析新生窒息患儿血气指标与1 min Apgar评分的相关性及新生窒息患儿血气指标与预后的相关性。结果观察组患儿PaCO_2、Lac及BE显著高于对照组,pH、PaO_2、HCO_3^-显著低于对照组,差异有统计学意义(P<0.05);重度窒息患儿中各项指标与轻度窒息患儿比较差异有统计学意义(P<0.05)。pH、PaO_2、PaCO_2与1 min Apgar评分呈相关,其中pH、PaO_2与1 min Apgar评分呈正相关(r=0.265、0.247,P<0.05),PaCO_2与1 min Apgar评分呈负相关(r=-0.218,P<0.05)。Lac与3、7、14 d日龄新生儿神经行为测定(NBNA)评分存在负相关(P<0.05),pH与3、7、14 d日龄NBNA评分存在正相关(P<0.05),HCO_3^-与3 d日龄NBNA评分存在正相关(P<0.05),BE与14 d日龄NBNA评分存在正相关(P<0.05)。结论新生儿窒息可引起血气分析的改变,动脉血血气指标及乳酸值分析较Apgar评分更敏感,更能直接地反映新生儿缺氧、酸中毒的程度。
Objective To analyze the correlation between blood gas index changes and prognosis in neonatal asphyxia. Methods There were 68 children with neonatal asphyxia as observation group, and another concurrent 46 children without neonatal asphyxia as control group. The blood gas index [ pH, partial pressure of carbon dioxide （PaCO2）, oxygen partial pressure （PaOz）, bicarbonate （HCO3-）, blood lactate （Lac） and base excess （BE） ] were observed between the two groups. The correlation between blood gas index and the 1 min Apgar score, blood gas index and prognosis of the neonatal asphyxia were analyzed. Results The observation group had obviously higher PaCO2, Lac and BE than the control group, and obviously lower pH, PaO2 and HCO3^- than the control group. Their difference was statistically significant （P〈0.05）. There was statistically significant differences between children with severe asphyxia and children with mild asphyxia （P〈0.05）. pH, PaO2, PaCO2 were significantly correlated with 1 rain Apgar score, of which pH, PaO2 and 1 min Apgar scores were positively correlated （r=0.265, 0.247, P〈0.05）. PaCO2 and 1 rain Apgar score were negatively correlated （r=-0.218, P〈0.05）. There was a significant negative correlation between Lac and neonatal behavioral neurological assessment （NBNA） scores at the age of 3, 7, and 14 d （P〈0.05）. pH had significant positive correlation with NBNA scores at the age of 3, 7, 14 d （P〈0.05）, and there was a significant positive correlation between HCO3- and NBNA score at the age of 3 d （P〈0.05）. BE had significant positive correlation with NBNA score at the age of 14 d （P〈0.05）. Conclusion Neonatal asphyxia can cause changes in blood gas analysis, arterial blood gas index and lactic acid value analysis are more sensitive than Apgar score, and can more directly reflect the degree of neonatal hypoxia and acidosis.
作者
张广清
葛晶晶
邹海珊
梁桂兰
黄毅
ZHANG Guang-qing;GE Jing-jing;ZOU Hai-shan(Qingyuan Maternal and Child Health Hospital, Qingyuan 511515, China)
出处
《中国实用医药》
2018年第14期4-6,共3页
China Practical Medicine
关键词
新生儿窒息
血气分析
酸中毒
Neonatal asphyxia
Blood gas analysis
Acidosis
