脐血血气测定的临床意义

OBSERVATION OF RELATIONSHIP AMONG MECONIUM AMNIOTIC FLUID, APGAR SCORE AND CORD BLOOD CAS

对56例正常、足月妊娠、顺产产妇的新生儿脐血血气进行检测。结果：（1）羊水Ⅱ°粪染组脐动、静脉血SaO2、PO2值低于正常羊水组（P＜0．05）；（2）羊水Ⅲ°粪染组脐动、静脉血pH、BE、HCO3、SB、PO2、SaO2值低于正常羊水组；PCO2值高于正常羊水组（P＜0．05或P＜0．01）；（3）Ⅲ°粪染羊水组脐动脉血酸血症发生率高于正常羊水组和Ⅱ°粪染羊水组；（4）新生儿轻度窒息组酸中毒发生率高于正常新生儿组（P＜0．01）。单独依据羊水粪染判断胎儿窘迫、诊断率较实际发生率高；而单独的Apgar评分对新生儿酸中毒的诊断率远低于济动脉血pH值测定法。因此诊断胎儿、新生儿酸中毒必须同时采用羊水粪染、Apgar评分及胎儿、新生儿血pH值以及气体分析等方法综合判断。

56 cord blood gas of neonates from normal labor and full-term parturients were deterhanated. The results showed that(a)SaO2,PO2 in the cord artery and vein of the Ⅱ meconium amniotic fluid group (the Ⅱ group)were lower than the control group (P<0.05 ). (b ) pH, BE, HCO3, SB, PO2, SaO2 of the Ⅲ meconium amniotic fluid group (the Ⅲ group)were lower but higher on PCO2 than the control group(P<0.05 or P<0.01 ). (c)Incidence of acidewha in the cord artery of the Ⅲ group was higher than the control group (P<0.01 )and the n group. (d)Incidence of acidosis of neonates asphykia group was higher than the normal group(P<0.01 ).Diagnosis rate of fetus distress was exactly higher than incidence only based on meconium arnniotic fluid. But diagnosis rate of neonatal acidosis was lower than pH determination in the cord artery significantly depend on Apgar score only.Therefore, except for meconium aniniotic fluid and Apgar score, pH and the bbod gas analysis of the fetus and neonates should be used as diagnosis indices of the acidosis.