脐动脉血气分析与Apgar评分在新生儿窒息评估中的临床价值

Clinical Value of Umbilical Artery Blood Gas Analysis and Apgar Score in the Evaluation of Neonatal Asphyxia

目的 分析在临床诊断新生儿窒息中,应用脐动脉血气分析与Apgar评分的临床价值。方法 选取2016年8月—2021年8月邳州市中医院收治的56例新生儿窒息患儿为观察组,选取同时期的1 208名健康新生儿为对照组。依据国际新生儿窒息诊断标准将56例患儿分为两组,A组:轻度窒息组(30例)、B组:重度窒息组(26例)。对比3组新生儿脐动脉血气分析指标、1min、5 min Apgar评分及临床表现。结果 B组患儿血pH、BE、HCO值分别为(6.80±0.07)、(-16.90±6.36)mmol/L、(13.02±2.52)mmol/L,均低于A组的(7.05±0.15)、(-12.02±3.31)mmol/L、(14.30±2.69)mmol/L及对照组的(7.35±0.42)、(-7.05±2.96)mmol/L、(20.12±3.08)mmol/L;Lac值为(10.05±2.74)mmol/L,高于A组的(8.35±1.24)mmol/L及对照组的(4.78±1.18)mmol/L,差异有统计学意义(F=29.905、165.976、118.686、348.488,P<0.05)。B组患儿1、5 min Apgar评分为(2.99±0.92)分、(3.51±0.48)分,低于A组的(6.32±0.67)分、(6.49±0.51)分及对照组的(8.45±1.44)分、(8.51±1.49)分,差异有统计学意义(F=218.122、174.115,P<0.05);伴随患儿代谢性酸中毒严重程度的增加,患儿临床表现比较,差异有统计学意义(χ^(2)=11.470、10.898、12.954、12.954,P<0.05),其发生HIE风险的概率也随之增加,差异有统计学意义(χ^(2)=10.821,P<0.05)。结论 在临床诊断新生儿窒息中,应用脐动脉血气分析与Apgar评分可为后续临床诊疗工作的开展提供科学参考,并指导新生儿复苏方案的选择,值得推广。

Objective To analyze the clinical value of combined umbilical artery blood gas analysis and Apgar score in the clinical diagnosis of neonatal asphyxia.Methods 56 children with neonatal asphyxia admitted to the Pizhou Hospital of Traditional Chinese Medicine from August 2016 to August 2021 were selected as the observation group.1 208 healthy newborns of the same period were selected as the control group.According to the international diagnostic criteria for neonatal asphyxia,56 infants were divided into two groups,group A:mild asphyxia group(30 cases),group B:severe asphyxia group(26 cases).The three groups of neonatal umbilical artery blood gas analysis indexes,1 min,5 min Apgar score and clinical manifestations were compared.Results The blood pH,BE and HCOvalues of children in group B were(6.80±0.07),(-16.90±6.36) mmol/L,(13.02±2.52) mmol/L,respectively,all were lower than(7.05±0.15),(-12.02±3.31) mmol/L,(14.30±2.69) mmol/L of group A and(7.35±0.42),(-7.05±2.96) mmol/L,(20.12±3.08) mmol/L of control group,the Lac value was(10.05±2.74) mmol/L,which was higher than(8.35±1.24) mmol/L in group A and(4.78±1.18) mmol/L in control group,the difference was statistically significant(F=29.905,165.976,118.686,348.488,P<0.05).The 1 min,5 min Apgar score of group B was(2.99±0.92) points,(3.51±0.48) points,lower than those of group A(6.32±0.67) points,(6.49±0.51) points and those of control group(8.45±1.44) points,(8.51±1.49) points,the difference was statistically significant(F=218.122,174.115,P<0.05).With the increase in the severity of metabolic acidosis in children,compared the clinical manifestations of children,the difference was statistically significant(χ^(2)=11.470,10.898,12.954,12.954,P<0.05),the probability of HIE risk also increased,and the difference was statistically significant(χ^(2)=10.821,P<0.05).Conclusion In the clinical diagnosis of neonatal asphyxia,the application of umbilical artery blood gas analysis and Apgar score can provide scientific reference for the follow-up clinical diagnosis and treatment,and guide the selection of neonatal resuscitation plan,which is worthy of promotion.