不同分娩方式的新生儿脐动脉血气分析比较

Effects of different delivery methods on umbilical artery blood gas analysis of infants

目的探讨两种分娩方式对新生儿脐动脉血气分析的影响及其对新生儿窒息的潜在影响。方法选取2016年10月至2017年1月于北部战区总医院和平分院足月分娩且无妊娠期合并症的产妇94例,分为剖宫产组(41例)及阴道分娩组(53例),对其脐动脉血气分析结果进行分析。结果剖宫产组新生儿脐动脉血pH(7.23±0.12)和动脉氧分压(arterial partial pressure of oxygen,PaO2)[(24±13)mmHg,1 mmHg=0.133 kPa]高于阴道分娩组[分别为(7.19±0.10)和(21±15)mmHg],差异有统计学意义(P<0.01)。剖宫产组脐动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_(2))[(52±10)mmHg]和乳酸浓度[(3.4±1.3)mmol/L]低于阴道分娩组[分别为(57±10)mmHg和(5.0±2.3)mmol/L],差异有统计学意义(P<0.01)。剖宫产组新生儿脐动脉血pH<7.15的发生率(4.9%)低于阴道分娩组(24.5%),差异有统计学意义(P<0.05)。剖宫产组新生儿酸中毒发生率(4.9%)低于阴道分娩组(24.5%),差异有统计学意义(P<0.05);剖宫产组新生儿乳酸异常率(17.1%)低于阴道分娩组(47.2%),差异有统计学意义(P<0.01)。结论出现产程异常、可疑胎儿窘迫、合并有母儿并发症等情况时剖宫产分娩较阴道分娩可能降低新生儿酸中毒风险。

Objective To explore the effects of two different delivery methods on umbilical artery blood gas analysis of infants and the potential effects on neonatal asphyxia.Methods From October 2016 to January 2017,94 women who delivered at term in Northern Theater General Hospital and Peace Branch without gestational complication were selected and divided into cesarean section group(41 cases)and vaginal delivery group(53 cases),the blood gas analysis results of umbilical artery of the two groups were analyzed.Results The pH of umbilical artery(7.23±0.12)and arterial partial pressure of oxygen(PaO2)value[(24±13)mmHg,1 mmHg=0.133 kPa]of newborn in cesarean section group were higher than those in vaginal delivery group[(7.19±0.10)and(21±15)mmHg,respectively],the differences were statistically significant(P<0.01).Arterial partial pressure of carbon dioxide(PaCO_(2))[(52±10)mmHg]and lactate[(3.4±1.3)mmol/L]of umbilical artery in cesarean section group were lower than those in vaginal delivery group[(57±10)mmHg and(5.0±2.3)mmol/L,respectively],with statistically significant differences(P<0.01).The incidence rate of umbilical arterial blood pH<7.15(4.9%)in the cesarean section group was lower than that in the vaginal delivery group(24.5%),the difference was statistically significant(P<0.05).The incidence of acidosis in the cesarean section group(4.9%)was lower than that in the vaginal delivery group(24.5%),and the difference was statistically significant(P<0.05).The abnormal rate of lactic acid in newborns in the cesarean section group(17.1%)was lower than that in the vaginal delivery group(47.2%),and the difference was statistically significant(P<0.01).Conclusion The risk of neonatal acidosis may be reduced in cesarean section compared with vaginal delivery in the cases of abnormal labor process,suspicious fetal distress,and complications of mother and child.