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目的研究脐动脉血气分析对新生儿窒息诊断的意义及预后的评估价值。方法连续纳入在我院分娩的新生儿3293例,对新生儿分娩后1min内的脐动脉血气进行分析,同时进行1minApgar评分并追踪新生儿脏器损伤的并发症。结果1minApgar评分与脐动脉血pH、PO2、BE呈正相关(r=0.994,r=0.941,r=1,P均<0.01),而与PCO2呈负相关(r=-0.902,P<0.01)。随着脐血pH值的降低,新生儿轻度窒息、重度窒息的出现率逐渐升高,二者呈负相关(r=-0.682,r=-0.656,P均<0.01);Apgar≥8分的出现率随脐血pH值的降低而降低,二者呈正相关(r=1.000,P<0.01)。随着脐血pH值的降低,HIE的发生率逐渐升高,二者呈负相关(r=-0.903,P<0.01)。随着脐血pH值的降低,新生儿脏器损伤的发生率逐渐升高,二者呈负相关(r=-0.651,P<0.01)。结论脐动脉血气是诊断新生儿窒息必不可少的标准之一,是Apgar评分的有效补充,应结合脐动脉血气和Apgar评分来综合评估新生儿的预后。
Objective To study the significance and prognostic value of umbilical artery blood gas analysis in the diagnosis of neonatal asphyxia. Methods 3293 newborn infants delivered in our hospital were enrolled in this study. Umbilical artery blood gas was analyzed within 1 minute after delivery and 1-minute Apgar score was used to track the complications of neonatal organ injury. Results The 1minApgar score was positively correlated with the umbilical arterial pH, PO2 and BE (r = 0.994, r = 0.941, r = 1, P <0.01) and negatively correlated with PCO2 (r = -0.902, P <0.01). With the decrease of umbilical cord blood pH, the incidence of mild asphyxia and severe asphyxia in neonates gradually increased, with a negative correlation (r = -0.682, r = -0.656, P <0.01); Apgar≥8 With the decrease of umbilical cord blood pH value, the two were positively correlated (r = 1.000, P <0.01). With the decrease of umbilical cord blood pH, the incidence of HIE gradually increased, the two was negatively correlated (r = -0.903, P <0.01). With the reduction of umbilical cord blood pH, the incidence of neonatal organ injury gradually increased, the two was negatively correlated (r = -0.651, P <0.01). Conclusion Umbilical arterial blood gas is one of the indispensable criteria for diagnosis of neonatal asphyxia. It is an effective supplement to Apgar score. Umbilical arterial blood gas and Apgar score should be used to evaluate the prognosis of neonates.