新生儿脐动脉血血气分析与乳酸测定的临床价值

Clinical Evaluation of the Cord Blood Gas Analysis and Lactic Acid Measurement in the Umbilical Artery of Newborns

目的探讨新生儿脐动脉血血气分析与乳酸测定的临床价值。方法选择住院足月分娩无妊娠并发症,分娩前脐动脉血流监测正常,产前、产时胎心监测正常,出生时Apgar评分≥8分的新生儿86例,在其出生后第一次啼哭前,立即钳夹脐带,抽取脐动脉血进行血气分析与乳酸测定,并观察其临床价值。结果脐动脉血pH值7.263±0.082,PaCO2(53.785±11.382)mmHg,BE(-4.41±3.55)mmol/L,乳酸(3.526±0.609)mmol/L。pH与乳酸呈显著负相关(r=-0.664,P<0.01),pH与PaCO2呈显著负相关(r=-0.701,P<0.01),pH与BE呈显著正相关(r=0.629,P<0.01)。脐动脉血pH及乳酸测定异常检出率的差异无统计学意义。结论脐动脉血血气分析与乳酸测定能更客观地反映胎儿缺血缺氧程度,有助于新生儿预后判断。

Objective To explore the clinical value of blood gas analysis and lactic acid measurement in the umbilical artery of the newborns. Methods The umbilical artery blood samples of 86 newborns were obtained immediately after delivery, and then blood gas analysis and lactic acid values were made within thirty minutes. Results The mean value of umbilical artery blood was： pH 7. 263 ±0. 082, PaCO2 （53. 785 ± 11. 382） mmHg, BE（ -4.41 ± 3.55 ）mmol/L, lactic acid（3.526 ± 0.609）mmol/L. The pH value had a significantly negative relationship with lactic acid value and PaCO2（r = - 0.664 and r= -0.701 respectively, P 〈0.01）, and a positive relationship with the BE（r =0.629, P 〈0.01 ）. The abnormal detection rate of the pH and lactic acid value had no significant difference. Conclusions The blood gas analysis and lactic acid measurement of newborn are objective in reflecting the degree of ischemia and hypoxia in fetus and beneficial to newborn prognosis judgement.