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目的探讨新生儿脐动脉血气分析和Apgar评分在诊断新生儿窒息中的临床意义。方法将Apgar评分8~10分的新生儿和Apgar评分≤7分的新生儿分别作为正常组和窒息组(4~7分为轻度窒息组,≤3分为重度窒息组),对两组的脐动脉血气检测结果进行对照研究,并分析不同Apgar评分与不同脐动脉p H值新生儿出生时脏器损伤发生情况。结果窒息组出生时脐动脉血p H<7.2的发生率明显高于正常组(P<0.05);轻度窒息组脐动脉血p H<7.2的发生率明显低于重度窒息组(P<0.05);窒息组脏器损伤发生率明显高于正常组(P<0.05);脐动脉血p H<7.2的新生儿脏器损伤发生率明显高于p H≥7.2的新生儿(P<0.05)。结论脐动脉血气分析评估新生儿窒息具有较好的准确性和可靠性,与Apgar评分有很好的互补性;Apgar评分与脐动脉血气分析结合,能有效提高新生儿窒息诊断准确性,降低误诊率。
Objective To investigate the clinical significance of neonatal umbilical artery blood gas analysis and Apgar score in the diagnosis of neonatal asphyxia. Methods Neonates with Apgar scores of 8 to 10 and neonates with Apgar score ≤ 7 were used as normal group and asphyxia group (4-7 in mild asphyxia group and ≤3 in severe asphyxia group) Umbilical arterial blood gas test results were compared for the control study and analysis of different Apgar scores and different umbilical arterial p H value of neonatal organ damage at birth. Results The incidence of umbilical arterial blood p H <7.2 at birth in asphyxia group was significantly higher than that in normal group (P <0.05). The incidence of umbilical arterial blood p H <7.2 in mild asphyxia group was significantly lower than that in severe asphyxia group (P 0.05 ). The incidence of organ damage in asphyxia group was significantly higher than that in normal group (P <0.05). The incidence of neonatal organ injury with p H <7.2 in umbilical artery was significantly higher than that in newborns with p H≥7.2 (P <0.05) . Conclusion Umbilical arterial blood gas analysis to evaluate neonatal asphyxia has good accuracy and reliability, and Apgar score with good complementarity; Apgar score and umbilical arterial blood gas analysis can effectively improve the diagnostic accuracy of neonatal asphyxia and reduce the risk of misdiagnosis rate.