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目的分析生后早期动脉血气分析与早产儿脑损伤的相关性,为早产儿脑损伤的早期发现和干预提供参考依据。方法收集2010年1月-2012年12月本院有生后1h内动脉血气分析结果的早产儿,抽取脑损伤早产儿51例,按1∶3比例抽取3份相同或相近孕周产科分娩的无脑损伤早产儿为对照组,对两组早产儿血气分析中PH值、PaO2、PaCO2、BE值与脑损伤关系进行比较,并进行相关性分析,探讨早期动脉血气分析与早产儿脑损伤的相关性,评估早期动脉血气分析在预测早产儿脑损伤中的价值。结果早产儿脑损伤检出率为16.4%,其中脑室内出血检出率为13.4%,脑室周围白质软化检出率为3.0%。脑损伤组PH(7.23±0.13)、PaO2(68.53±30.85)、BE(-6.50±3.93)值较对照组PH(7.32±0.08)、PaO2(81.05±29.19)、BE(-4.04±3.66)明显降低(P均<0.01)。PaCO2(50.16±14.13)较对照组(44.30±10.27)明显升高(P<0.01)。进一步研究发现:当PH<7.15、PaO2<35mmHg、PaCO2>65mmHg、BE<-10mmol/L时,早产儿脑损伤发生率明显增加。Logistic回归分析显示:PH<7.15、PaO2<35mmHg、PaCO2>65mmHg与早产儿脑损伤密切相关,OR值(95%CI)分别为0.14(0.03~0.68)、0.04(0.01~0.68)、0.06(0.01~0.55)。结论早期动脉血气分析异常与早产儿脑损伤密切相关,早产儿脑损伤发生率明显增加,提示早期监测动脉血气分析,及时纠正低氧血症、高碳酸血症、代谢性酸中毒,可减轻早产儿脑损伤发生发展。
Objective To analyze the correlation between arterial blood gas analysis in early postnatal period and brain injury in premature infants, and to provide a reference for the early detection and intervention of premature infants with brain injury. Methods Preterm infants with arterial blood gas analysis within 1 h after birth were collected from January 2010 to December 2012 in our hospital. Totally 51 preterm infants with brain injury were selected. Three identical or similar gestational weeks of obstetric delivery The comparison of PH value, PaO2, PaCO2, BE value and brain injury in the blood gas analysis of two groups of preterm infants was carried out as the control group, and the correlation analysis was conducted to explore the relationship between early arterial blood gas analysis and brain injury in premature infants Correlation, Assessing the Value of Early Arterial Blood Gas Analysis in Predicting Brain Injury in Premature Infants. Results The detection rate of brain injury in preterm infants was 16.4%. The detection rate of intracerebral hemorrhage was 13.4% and the rate of periventricular leukomalacia was 3.0%. The values of PH (7.23 ± 0.13), PaO2 (68.53 ± 30.85) and BE (-6.50 ± 3.93) in brain injury group were significantly higher than those in control group (7.32 ± 0.08), PaO2 (81.05 ± 29.19), BE (-4.04 ± 3.66) Decreased (P <0.01). PaCO2 (50.16 ± 14.13) was significantly higher than the control group (44.30 ± 10.27) (P <0.01). Further study found that: when the PH <7.15, PaO2 <35mmHg, PaCO2> 65mmHg, BE <-10mmol / L, the incidence of brain injury in preterm infants was significantly increased. Logistic regression analysis showed that the values of OR (95% CI) were 0.14 (0.03-0.68), 0.04 (0.01-0.68) and 0.06 (0.01), respectively, with PH <7.15, PaO2 <35mmHg and PaCO2> 65mmHg. ~ 0.55). Conclusion Early arterial blood gas analysis is closely related to brain injury in preterm infants. The incidence of brain injury in preterm infants is significantly increased, which indicates early monitoring of arterial blood gas analysis and timely correction of hypoxemia, hypercapnia and metabolic acidosis, which can reduce preterm birth Brain damage occurs.