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目的:分析分娩方式、早产以及其他围产期相关因素对新生儿脐血血气相关指标及Apgar评分的影响。方法:收集2 379例新生儿的脐血血气分析资料、分娩方式、孕周、出生体重、妊娠并发症和合并症等围产期高危因素,将脐血血气分析结果及1 min Apgar评分与相关因素进行分析。结果:自然分娩与剖宫产分娩新生儿的脐动脉血气pH、PO2和PCO2差异没有统计学意义。早产儿与足月儿的1 min Apgar评分构成比存在显著性差异,而两者脐血pH的构成比差异没有显著性意义。有无产前并发症和合并症、巨大儿、早产儿、低体重儿、胎窘和难产等围产期高危因素的两组新生儿脐血pH值和1 min Apgar评分均存在显著性差异。多因素分析提示对新生儿脐血pH有影响的主要因素是初产、足月产、巨大儿和羊水污染。结论:分娩方式对新生儿脐血pH、PO2和PCO2影响不大;单纯用Apgar评分评价早产儿窒息存在不足,应结合脐动脉血气结果进行窒息诊断;初产者、足月儿、巨大儿和羊水污染者脐血pH值偏低。
Objective: To analyze the effects of mode of delivery, premature labor and other perinatal factors on neonatal cord blood-related blood gas-related index and Apgar score. Methods: Blood samples from 2 379 newborns were collected for blood gas analysis, gestational age, gestational age, gestational age, gestational complications and complications. Cord blood blood gas analysis results and 1 min Apgar scores were correlated Factors for analysis. Results: There was no significant difference in pH, PO2 and PCO2 in neonatal umbilical artery blood between spontaneous delivery and cesarean delivery. There was a significant difference in the constituent ratio of 1 minute Apgar score between preterm and term infants, but there was no significant difference between the two groups in the constituent ratio of umbilical blood pH. Prenatal complications and complications, macrosomia, premature children, low birth weight children, fetal distress and dystocia and other perinatal high risk factors of neonatal umbilical blood pH value and 1 min Apgar scores were significantly different. Multivariate analysis showed that the main factors influencing neonatal umbilical blood pH were primiparous, full-term labor, macrosomia and amniotic fluid contamination. Conclusion: The mode of delivery has little effect on neonatal umbilical cord blood pH, PO2 and PCO2. Apgar score apropos of apnea in preterm infants is not enough. Asphyxia should be diagnosed in combination with umbilical artery blood gas. Amniotic fluid polluters umbilical cord blood pH value is low.