新生儿脐动脉血pH值的影响因素分析

Influence factors for neonatal cord blood pH value

目的分析新生儿脐动脉血气参数,探讨影响新生儿脐动脉血pH值的因素。方法选取2020年1—3月于该院出生的3587例新生儿为研究对象,统计3115例Apgar评分正常的健康足月新生儿脐动脉血气参数的参考值范围;对分娩方式、是否早产、羊水情况、围生期并发症等可能影响新生儿脐动脉血pH值的相关因素进行多重线性回归分析。结果3115例健康足月新生儿脐动脉血pH值、脐动脉血碱剩余(BE)、动脉血氧分压(PaO_(2))与动脉血二氧化碳分压(PaCO_(2))、乳酸(LAC)水平的参考范围分别为7.30±0.10、(-3.47±1.87)mmol/L、(32.98±21.23)mm Hg、(41.89±16.93)mm Hg、(4.79±1.32)mmol/L。多重线性回归分析提示早产、巨大儿、宫内窘迫、产钳助产、母亲患糖尿病或心脏病、羊水浑浊、胎盘异常和脐带异常者脐动脉血pH值更低。结论早产儿、巨大儿、宫内窘迫、产钳助产、母亲患糖尿病或心脏病者、羊水浑浊、胎盘异常和脐带异常者脐动脉血pH值异常更显著,需加强监测,以减少该部分新生儿窒息的发生。

Objective To statistically analyze blood gas indexes of neonatal cord blood,and to explore related factors influencing neonatal cord blood pH value in order to reduce occurrence of neonatal asphyxia.Methods A total of 3587 neonates born in the hospital from January to March 2020 were enrolled.The range of normal reference values for cord blood gas indexes in 3115 healthy term neonates with normal Apgar scores were statistically analyzed.Related factors that might influence neonatal cord blood pH value such as mode of delivery,premature delivery,amniotic fluid and perinatal complications were analyzed by multiple linear regression analysis.Results The statistical reference ranges of neonatal pH value,umbilical arterial blood base excess(BE),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))and lactate(LAC)in 3115 healthy term neonates were 7.30±0.10,(-3.47±1.87)mmol/L,(32.98±21.23)mm Hg,(41.89±16.93)mm Hg and(4.79±1.32)mmol/L,respectively.Multiple linear regression analysis showed neonates who were preterm delivery,macrosomia,suffering from intrauterine distress,force-delivery,and whose mothers had diabetes or heart disease,amniotic fluid turbidity,placenta and umbilical cord abnormalities had lower cord blood pH value.Conclusion Premature neonates,macrosomia,neonates who suffers from intrauterine distress,forceps delivery,whose mothers have diabetes or heart disease,amniotic fluid turbidity,placenta and umbilical cord abnormality are more likely to have abnormal cord blood pH value,and enhanced surveillance is needed to reduce the occurrence of neonatal asphyxia.