脐血血气分析与胎心监护图形预测胎儿宫内窘迫的临床价值

Predictive Value of Fatal Heart Rate Monitoring and Gas Analysis of Umbilical Artery Blood for Fatal Distress

目的结合脐血血气,探讨不同类型胎心监护图形预测胎儿窘迫的临床价值。方法测定68例胎心监护图形为不良图形(早期减速、晚期减速、轻度变异减速、重度变异减速、轻度心动过速)的新生儿(观察组)和20例胎心监护正常图形的新生儿(对照组)出生后脐动脉血血气分析值,血气测其pH、BE、PCO2、PO2值。结果观察组与对照组血气分析中pH、BE、PCO2、PO2等对应指标比较差异无显著性(P均>0.05)。观察组中,重度变异减速者及晚期减速者pH、PCO2、PO2、BE与对照组相比差异非常显著(P均<0.01)。轻度心动过速、轻度变异减速、早期减速者的pH、PCO2、PO2、BE与对照组相比差异均无显著性(P>0.05)。结论胎心监护不良图形中重度变异减速与晚期减速与胎儿窘迫的发生密切相关。早期减速、轻度心动过速及轻度变异减速与胎儿窘迫的发生无必然联系。

Objective To explore the predictive value of umbilical artery blood gas analysis with evaluation of different type of fatal heart rate（FHR） monitoring patents for fatal distress. Methods There were 68 neonates with abnormal fetal heart rate monitoring patterns in the observe group. The abnormal patterns included early decelerations（ED）,late decelerations（LD）,mild variable decelerations, severe variable decelerations and mild tachycardia. There were 20 neonates with normal fetal heart rate monitoring patterns in the control group. All neonatal umbilical artery blood gas analysis was measured in ten min after delivery. Results As for umbilical artery blood gas analysis, there were no significant differences between the observe group and the control group （P〈0.05）. In the group of severe variable deceleration and late deceleration, the value of pH,PCO2 ,Base excess and PO2 had significant differences from that in the control group（P〈0. 01）. As for umbilical artery blood gas analysis, there were no differences between the groups of early deceleration, mild variable deceleration and mild tachycardia and the control group （P〉 0. 05）. Conclusion In the abnormal FHR patterns,there is a close correlation between severe variable deceleration and late deceleration with fatal distress. There is no certainly correlation between early deceleration, mild variable deceleration and mild tachycardia with fatal distress. It should be evaluated later.