脐血血气分析在早产儿窒息诊断中的价值及影响因素分析

Value of umbilical cord blood gas analysis in diagnosis of asphyxia in preterm infants and analysis on the influencing factors

目的探讨脐血血气分析在早产儿窒息诊断中的价值及影响因素,为及早准确诊断早产儿窒息并改善其预后提供重要依据。方法回顾性分析70例早产儿及170例正常足月新生儿资料,出生后立即采集脐动脉血进行血气分析,同时进行Apgar评分,进行对照研究,比较早产儿与正常足月新生儿、窒息早产儿与正常足月新生儿、窒息早产儿与非窒息早产儿以及非窒息早产儿与正常足月新生儿之间的p H及碱剩余(BE)值,并应用多因素回归分析分析窒息的影响因素。结果早产儿与正常足月新生儿之间p H及BE值无统计学差异,窒息早产儿与正常足月新生儿、窒息早产儿与非窒息早产儿之间p H及BE值有统计学差异,非窒息早产儿与正常足月新生儿之间p H及BE值无统计学差异。胎龄是早产儿窒息的独立危险因素,胎盘早剥及胎膜早破是早产儿窒息的危险因素。结论联合应用脐血血气分析及Apgar评分可提高早产儿窒息诊断的准确性,酸中毒与窒息早产儿的预后密切相关。要重视妊娠期及分娩期并发症,重视早产儿窒息的诊断、治疗。

Objective To explore the value of umbilical cord blood gas analysis in diagnosis of asphyxia in preterm infants and the influencing factors, provide an important basis for early and accurate diagnosis of asphyxia in preterm infants and improvement of prognosis. Methods The clinical data of 70 preterm infants and 170 normal full-term neonates were analyzed retrospectively, umbilical cord blood gas analysis was performed immediately after birth, Apgar score was conducted at the same time. A case-control study was performed to compare pH values and base excess values between premature infants and normal full-term infants, preterm infants with asphyxia and normal fullterm infants, premature infants with asphyxia and premature infants without asphyxia, premature infants without asphyxia and normal fullterm infants. Multivariate regression analysis was used to analyze the influencing factors of asphyxia. Results There was no statistically significant difference in pH value and base excess value between preterm infants and normal full-term infants; there were statistically significant differences in pH value and base excess value between premature infants with asphyxia and normal full-term infants, as well as between pre- mature infants with asphyxia and premature infants without asphyxia. There was no statistically significant difference in pH value and base excess value between premature infants without asphyxia and normal full-term infants. Gestational age was an independent risk factor for preterm infants with asphyxia, placental abruption and premature rupture of membranes were risk factors. Conclusion Umbilical cord blood gas analysis combined with Apgar score can improve the accuracy of diagnosis of asphyxia in preterm infants. Acidosis is closely related to prognosis of premature infants. Importance should be attached to pregnancy and delivery complications, diagnosis and treatment of asphyxia in premature infants.