动脉血乳酸水平和NBNA评分与新生儿窒息的相关性

目的探讨动脉血乳酸水平、新生儿20项行为神经评分法(NBNA)评估新生儿窒息的应用价值并进行相关性分析。方法收集100例新生儿窒息患儿作为观察组,依据1 min的Apgar评分分为轻度窒息组(60例)和重度窒息组(40例),另选择同期娩出的100例正常新生儿作为对照组,比较两组新生儿出生2 h后的动脉血乳酸水平、血pH值、BE值以及出生后14天的NBNA评分,分析血乳酸水平、pH值、BE值及NBNA评分与新生儿窒息的相关性。结果观察组的动脉血乳酸水平为(6.33±3.31)mmol/L,高于对照组。重度窒息组的动脉血乳酸水平为(8.06±3.46)mmol/L,高于轻度室息组轻度窒息组、重度窒息组及正常对照组的NBNA评分比较,差异有统计学意义(P<0.05)。相关性分析显示,乳酸水平与pH值、BE值、出生后14天的NBNA评分均呈负相关(P<0.05)。结论生产时发生室息的新生儿动脉血乳酸水平明显升高,动脉血乳酸水平可协助新生儿窒息的诊断,与NBNA评分可用于早期评估脑损伤可能,对新生儿窒息的预后具有提示作用。

Objective To investigate the application value of arterial blood lactate level and neonatal behavioral nerve score(NBNA)in neonatal asphyxia.Methods A total of 100 neonates with asphyxia were selected as the observation group and divided into mild asphyxia group(60 cases)and severe asphyxia group(40 cases)according to Apgar score for 1 min.Another 100 normal neonates delivered at the same time were selected as the control group.Arterial lactate level,pH value,BE value and NBNA score were compared 2 h after birth and 14 days after birth,and the correlation between arterial lactate level,pH value,BE value and NBNA score and neonatal asphyxia was analyzed.Results The level of arterial lactate in the observation group was(6.33±3.31)mmol/L,which was higher than that in the control group.The level of arterial lactate in the severe asphyxia group was(8.06±3.46)mmol/L,which was higher than that in the mild asphyxia group.The NBNA score of the mild asphyxia group,the severe asphyxia group and the normal control group showed statistical significance(P<0.05).Correlation analysis showed that lactic acid level was negatively correlated with pH value,BE value,and NBNA score at 14 days after birth(P<0.05).Conclusion The level of arterial lactate is significantly increased in neonates with asphyxia during labor.The level of arterial lactate can assist in the diagnosis of neonatal asphyxia,and NBNA score can be used for the early assessment of the possibility of brain injury,which has a role in the prognosis of neonatal asphyxia.