围产期窒息新生儿严重高乳酸血症快速清除治疗研究

Quick removal treatment research of perinatal asphyxia neonatal high severe lactic acidosis

目的探讨围产期窒息新生儿高乳酸血症快速清除治疗的方法及临床价值。方法在连续监测动脉血乳酸基础上,运用快速扩容、循环支持或同时运用氧疗、呼吸支持、纠酸治疗,监测围产期窒息高乳酸血症患儿52例的各时段乳酸清除率,并进行分析比较,观察病死率、预后。结果 52例患儿出生后3、6 h乳酸明显下降,乳酸清除率增高,3 h乳酸清除率(57.33±20.44)%,6 h乳酸清除率(79.76±8.60)%;治疗初始及治疗3、6 h的乳酸、乳酸清除率比较差异有统计学意义(P<0.01);治愈52例(100.00%),所有患儿随访至出生后6个月生长发育正常。结论对围产期窒息高乳酸血症患儿运用快速扩容、循环支持、呼吸支持、纠正酸中毒等清除乳酸的治疗方法可靠、有效、便于推广。

Objective To investigate the quick removal treatment research of perinatal asphyxia neonatal high severe lactic aci-dosis and the clinical value. Methods Based on continuous monitoring arterial blood lactic acid,the use of rapid expansion,loop support or use oxygen therapy,respiratory support,acid treatment and monitoring of perinatal asphyxia high in each period of 52 children with lactic acidosis,lactate clearance rate,and carries on the analysis comparison,the mortality and prognosis was ob-served. Results The levels of lactic acid at 3,6 hours significantly reduced,the clearance of lactic acid increased,the lactate clearance at 3 hours was（57. 33 ±20. 44）% ,the lactate clearance at 6 hours was（79. 76 ±8. 60）% ,there were significant differ-ences（P 〈0. 01）. All of the 52 cases（100. 00% ）were cured,the growth and development of the 52 cases was normal during the follow up of 6 months after birth. Conclusion For perinatal asphyxia children with high blood lactic acid,rapid expansion,loop support,respiratory support,rectifying acid remove lactic acid treatment methods is reliable,effective,easy to promote.