脐动脉血气分析联合呼吸评分在评估新生儿缺血缺氧性脑病患儿病情严重程度中的价值分析

Analysis on values of umbilical arterial blood gas analysis combined with respiratory score in evaluating the severity of neonates with hypoxic ischemic encephalopathy

目的分析脐动脉血气分析联合呼吸评分在评估新生儿缺血缺氧性脑病(HIE)患儿病情严重程度中的临床价值。方法选取本院儿科2016年1月~2018年12月住院治疗的103例HIE患儿作为研究对象,根据临床分度相关标准将上述患儿分为轻度组(34例)、中度组(37例)和重度组(32例),同期选取30例正常新生儿作为对照组。检测各组新生儿脐动脉血p H值、二氧化碳分压(PCO2)、氧分压(PO2)、碱剩余(BE)、碳酸氢根(HCO3-)等血气分析指标,采用新生儿呼吸评分法对各组新生儿呼吸状态予以评估。比较HIE患儿及正常新生儿脐动脉血气分析相关指标及呼吸评分,比较不同病情严重程度HIE患儿脐动脉血气分析相关指标及呼吸评分。结果 HIE患儿pH值、PO2、HCO3-均明显低于正常新生儿(P <0.05),而PCO2、BE、呼吸评分均明显高于正常新生儿(P <0.05);不同病情严重程度HIE患儿脐动脉血气分析相关指标及呼吸评分比较均差异有统计学意义(P <0.05),且随着病情加重pH值、PO2、HCO3-等指标明显降低(P <0.05),而PCO2、BE、呼吸评分明显升高(P <0.05)。结论脐动脉血气分析联合呼吸评分在新生儿HIE患儿病情严重程度评估中具有较高的临床价值。

Objective To analyze the clinical values of umbilical arterial blood gas analysis combined with respiratory score in evaluating the severity of neonates with hypoxic ischemic encephalopathy(HIE). Methods 103 children with HIE who were hospitalized in department of pediatrics in our hospital from January 2016 to December 2018 were selected research objects. These children were divided into mild group(34 cases),moderate group(37 cases)and severe group(32 cases)according to relevant criteria for clinical grading.30 normal newborns during the same period were selected as the control group.The blood gas analysis indicators of neonatal umbilical artery blood such as p H,PCO2,PO2,BE,HCO3-were detected in each group. Blood gas analysis indexes such as p H value,carbon dioxide partial pressure(PCO2),oxygen partial pressure(PO2),base excess(BE),and bicarbonate(HCO3-)of neonatal umbilical arteries were measured.Neonatal respiratory scores were used to assess the respiratory status of neonates in each group.Related indiexes of umbilical arterial blood gas analysis and respiratory scores in children with HIE and normal newborns were compared.The related indexes of umbilical arterial blood gas analysis and respiratory scores of children with different severity of HIE were compared. Results The p H value,PO2,HCO3- of HIE children were significantly lower than those of normal newborns(P < 0.05),while the PCO2,BE and respiratory scores were significantly higher than those of normal newborns(P < 0.05).There were significant differences in umbilical artery blood gas analysis and respiratory scores among children with different severity of HIE(P < 0.05).With the aggravation of illness, the indexes such as p H value,PO2,HCO3- decreased significantly(P < 0.05),while PCO2,BE and respiratory scores increased significantly(P < 0.05). Conclusion Umbilical arterial blood gas analysis combined with respiratory score have high clinical values in evaluating the severity of neonatal HIE.