脐动脉血气分析及乳酸值评价围生儿的意义

Significance of Umbilical Cord Arterial Blood Gas Analysis and Lactate Values to Assess the Perinatals

由围生儿引起的产科纠纷日益增多,单凭Apgar评分来诊断围生儿窒息因受主观因素影响,特异性差,致产科医师处于无证可循状态。在胎儿出生时立即脐动脉血检测,是胎儿血气和酸碱状况最客观、最可靠的指标,也是分析产程事件和新生儿之间关联的重要证据。但仅从血pH正常不能否定胎儿缺氧,而脐动脉血乳酸与血pH至显著负相关,表明脐动脉血乳酸是一种诊断胎儿窘迫的方法,能否得到及时干预将影响新生儿预后,避免误诊和不必要的法律纠纷。

Obstetrical related medical tangles caused by perinatal is increasing.Diagnosis of perinatal asphyxia only via Apgar score is poor in specificity because it can be affected by many subjective factors,which then make obstetricians have no objective evidences to support their diagnosis.Researches proved that test results of the umbilical artery blood immediately after birth are highly objective and reliable in reflecting the blood gas and acid-base condition.Moreover,the results can also be a significant evidence to analyze the relation between newborn and labor process incidents.However normal blood pH cannot argue that there is no threat of fetal hypoxia,since lactic acid has a negative relation with blood pH which indicates that the lactic acid of umbilical artery blood can be a useful index to diagnose the fatal distress.Timely intervention has a great impact on the neonatal prognosis,to prevent the misdiagnosis and avoid unnecessary legal disputes.