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目的探讨脐动脉血气分析与Apgar评分的关系及其联合应用的临床意义。方法新生儿出生后开始呼吸之前立即抽取脐动脉血0.1ml测血气分析,同时对新生儿进行1min Apgar评分,并跟踪新生儿的临床预后。结果 1.胎儿窘迫组脐血pH值为7.22±0.09,无胎儿窘迫脐血pH值为7.18±0.11,两组比较,差异有统计学意义(P<0.05)。2.随着1min Apgar评分的减少,新生儿脐动脉血pH值、PaO2、HCO3-及BE值相应降低,两者呈正相关(均P<0.01),而PCO2值相应增加,两者呈负相关(P<0.01)。3.Apgar评分正常组、轻度窒息组与重度窒息组pH值、HCO3-、BE及PaCO2各均数比较,差异均有显著性意义(P<0.01),而PO2轻度窒息组与重度窒息组间比较,差异无统计学意义(P>0.01)。4.在pH<7.20的48例新生儿中有5例发生新生儿缺氧缺血性脑病(HIE),pH≥7.20的105例新生儿中有2例发生HIE,两组比较有显著性差异(P<0.05)。结论脐动脉血气分析联合Apgar评分能更客观、更灵敏的反应胎儿及新生儿缺氧、缺血的性质及严重程度,并有利于估计新生儿预后。
Objective To investigate the relationship between umbilical artery blood gas analysis and Apgar score and its clinical significance. Methods The newborns were asked to take 0.1ml blood samples of umbilical artery immediately before they began to breathe, and Apgar score of 1min was also measured. The clinical prognosis of neonates was also tracked. Fetal distress group umbilical cord blood pH value of 7.22 ± 0.09, no fetal distress umbilical blood pH value of 7.18 ± 0.11, the two groups, the difference was statistically significant (P <0.05). With the decrease of Apgar score at 1 minute, the umbilical arterial blood pH, PaO2, HCO3- and BE decreased correspondingly (all P <0.01), while the PCO2 increased correspondingly (P <0.01). There was significant difference between the normal group, mild asphyxia group and severe asphyxia group (P <0.01), but there was no significant difference between the mild asphyxia group and severe asphyxia group (P <0.01) There was no significant difference between groups (P> 0.01). In 5 of 48 neonates with pH <7.20, HIE occurred in 2 of 105 newborns with pH≥7.20, there was a significant difference between the two groups (P <0.05). Conclusion Umbilical arterial blood gas analysis combined with Apgar score can reflect the nature and severity of hypoxia and ischemia of fetus and newborn more objectively and more sensitively and is helpful to estimate the prognosis of newborn.