复杂型可变减速脐动脉血气分析的临床意义

Clinical Significance of Umbilical Arterial Blood Gas Analysis in Complcated Variable Deceleration

目的:探讨胎心电子监护复杂型可变减速脐动脉血气分析的临床意义。方法:对2007年10月至2011年2月在我院分娩并行产时胎心电子监护可变减速的270例患者进行回顾性分析。其中单纯型可变减速123例(单纯型组),复杂型可变减速147例(复杂型组),以正常胎心电子监护病例176例作为对照组。比较分析各组间脐动脉血气分析结果和分娩结局。结果:复杂型组脐动脉血pH值(7.21±0.07)与单纯型组(7.25±0.09)和对照组(7.26±0.06)比较,差异有统计学意义(P<0.05),单纯型组和对照组比较,差异无统计学意义(P>0.05)。复杂型组碱剩余水平(4.68±2.85mmol/L)与单纯型组(3.62±2.78mmol/L)和对照组(3.30±2.76mmol/L)比较,差异有统计学意义(P<0.05),单纯型组和对照组比较,差异无统计学意义(P>0.05)。复杂型组新生儿窒息(11例)发生例数与单纯型组(1例)及对照组(1例)比较,差异有统计学意义(P<0.05)。复杂型组脐动脉血pH<7.0和碱剩余<-12mmol/L的发生率较单纯型组和对照组高,差异有统计学意义(P<0.05)。结论:复杂型可变减速与脐动脉血pH值和碱剩余水平密切相关,提示胎儿可能存在酸中毒,新生儿发生不良结局可能性大。

Objective：To study the clinical significance of umbilical arterial blood gas analysis in complcated variable deceleration during electronic fetal heart rate monitoring.Methods：270 cases with variable decelerations,which were found during labor in our hostpital from October 2007 to February 2011,were retrospectively analyzed.123 cases were simple variable deceleration（simple group）,147 cases were complicated variable deceleration（complicated group）.176 normal monitoring cases were taken as control group.Umbilical arterial blood gas analysis and fetal outcomes were comparatively analyzed among these groups.Results：The umbilical arterial blood pH level in complicted group（7.21 ± 0.07） was significantly differentfrom the level in simple group（7.25 ± 0.09） and in control group（7.26 ± 0.06）（P0.05）.There was no statistical difference on pH level beween simple group and control group（P0.05）.For the base excess level,complicated group（4.68±2.85 mmol/L） was markedly different from that in simple group（3.62±2.78 mmol/L） and control group（3.30±2.76 mmol/L）（P0.05）.There was no difference on base excess level beween simple group and control group（P0.05）.Neonatal hasphyxia in complicated group（11cases）were much more than that in simply group（1 case） and control group（1 case）（P0.05）.There were more cases of pH level7.0 and base excess -12 mmol/L in complicated group than simple or control group（P0.05）.Conclusions：Complicated variable deceleration has correlation with umbilical arterial pH level and base excess level,which hints fetus acidosis and neonatal possible bad outcomes.