脐动脉血pH值对评价新生儿窒息的应用价值研究

The research of clinical application value in evaluating the newborn asphyxia with Umbilical arterial blood pH value

目的探讨研究脐动脉血pH值对评价新生儿窒息的应用价值。方法从2011年6月～2012年12月于本院阴道分娩的新生儿中随机抽取480例新生儿,将其依据新生儿Apgar评分分为正常组(Apgar评分>7分)和窒息组(Apgar评分≤7分),对新生儿的脐动脉血pH值进行监测,分析研究其与Apgar评分间的关系。结果 Ap-gar评分>7分462例、Apgar评分≤7分18例;脐动脉血pH值检测:pH≥7.20共461例,pH﹤7.20共19例;脐动脉血pH值与新生儿1min内Apgar评分呈正相关,并且正常组和窒息组pH值差异显著具有统计学意义(P<0.05)。脐动脉血pH值的敏感度和特异度分别为90.0%、99.8%,Apgar评分的敏感度和特异度分别为45.0%、98.0%,差异有统计学意义(P<0.05)。pH值异常与羊水污染度呈正相关,随着污染度加重发生率上升,差异显有统计学意义(P<0.05)。结论对于评价新生儿窒息,脐动脉血pH值比Apgar评分有更高的敏感度和特异度,能直接揭示窒息的病理生理本质和反映缺氧、酸中毒的严重程度,对及时采取措施防止并发症的发生有重要意义,应在临床中推广应用。

Objective To research clinical application value in evaluating the newborn asphyxia with umbilical arterial blood pH. Methods Four hundred and eighty cases of vaginal delivery newborns were random sampled in our hospital from June 2011 to December 2012, according to Apgar score, the newborn were divided into normal group （Apgar score 〉 7） and suffocation group（less Apgar score ≤7）, tsted umbilical artery blood pH value, analyzed and researched of the relationship between Apgar score and umbilical artery blood pH value. Results Apgar score 〉 7 （n = 462）, Apgar score ≤ （n=18）; Umbilical arterial blood pH value detection： pH ≥ 7.20 （n=461）, pH 〈 7.20 （n=19）. Umbilical arteri- al blood pH value and neonatal Apgar score 1 minutes were positively correlated, and the difference between normal group and the suffocation group pH value has significant difference （P 〈 0.05）. The sensitivity and specific degree of Um- bilical arterial blood pH value were 90.0% and 99.8% respectively, Apgar score were 45.0% and 98.0% respectively, difference was significant （P 〈 0.05）. pH value anomaly has relationship with amniotic fluid pollution ,occuring followed with the riseing of amniotic fluid pollution, with significant difference （P〈 0.05）. Conclution For evaluation of the new- born asphyxia, umbilical arterial blood pH value has higher sensitivity and specific degrees than Apgar score, it can directly reveal choking pathophysiological essence and reflect the severity of the oxygen, acidosis, for takeing timely measures to prevent the occurrence of complications ,it is important and should be used in the clinical application.