脐动脉血血气分析在新生儿缺氧缺血脑病严重程度评估中的临床应用价值

Study on Indexes of Umbilical Arterial Blood Gas Analysis in Evaluating the Severity of Neonates with Hypoxic Ischemic Encephalopathy

目的:探讨脐动脉血血气分析在评估新生儿缺氧缺血性脑病(HIE)病情严重程度中的临床应用价值。方法:将本院2017年1月-2020年1月新生儿科收治的90例HIE患儿纳入研究组,根据病情严重程度分为轻度组(50例)、中度组(25例)、重度组(15例);取同时间段50例健康新生儿纳入对照组。对两组新生儿脐动脉血进行血气分析(BG)指标检测,包括pH、二氧化碳分压(PCO_(2))、氧分压(PO_(2))、碱剩余(BE)、碳酸氢根(HCO_3^(-))等,并进行相应比较。结果:与对照组相比,研究组患儿中pH、PO_(2)、HCO_(3)^(-)均显著低(P<0.05),而PCO_(2)、BE均显著高(P<0.05);轻度组、中度组、重度组患儿中上述BG相关指标差异均有统计学意义(P<0.05),且病情越重,pH、PO_(2)、HCO_(3)^(-)指标越低(P<0.05),而PCO_(2)、BE越高(P<0.05)。结论:脐动脉血BG在评估新生儿HIE病情严重程度方面具有较高的临床应用价值,是重要的诊断指标。

Objective:To explore the clinical value of indexes of umbilical arterial blood gas analysis in evaluating the severity of neonates with hypoxic ischemic encephalopathy(HIE).Method:A total of 90 newborn children with HIE admitted to the Department of Neonatal Pediatrics of author’s hospital from January 2017 to January 2020 were included in the research group.According to the severity of the disease,newborn children with HIE were divided into mild group(n=50),moderate group(n=25)and severe group(n=15),and 50 healthy newborns in the same period were included in the control group.The blood gas analysis indicators of neonatal umbilical artery blood in two group were detected and compared,including pH value,arterial partial pressure of carbon dioxide(PCO_(2)),arterial partial pressure of oxygen(PO_(2)),alkali residual(BE),bicarbonate(HCO_(3)^(-)).Result:Compared with the control group,the pH value,PO_(2),HCO_(3)^(-)of the research group were much lower(P<0.05),while PCO_(2)and BE were much higher(P<0.05).The above indexes of mild group,moderate group and severe group had big differences among the three groups(P<0.05).With the aggravation of illness,the indexes such as pH value,PO_(2),HCO_(3)^(-)decreased significantly(P<0.05),while PCO_(2)and BE increased significantly(P<0.05).Conclusion:Umbilical arterial blood gas analysis has high clinical values in evaluating the severity of neonatal HIE and is an important diagnostic indicator.