剖宫产与经阴道分娩新生儿脐动脉血气对比分析

Comparative analysis of umbilical arterial blood gas between cesarean delivery and Vaginal delivery of newborns

目的比较剖宫产分娩与经阴道分娩新生儿脐动脉血气值,评估不同分娩方式对新生儿血气值的影响。方法回顾性分析北京市昌平区医院2021年1月-2021年8月足月分娩的37-41周新生儿病例(n=377),按照分娩方式分为两组,剖宫产分娩组(n=222)和经阴道分娩组(n=155)。对比两组新生儿出生后的脐动脉血气分析数值。结果剖宫产分娩组的新生儿脐血酸碱度pH值、乳酸Lac值、剩余碱BE值、标准碳酸氢根SB值均高于经阴道分娩组,差异有统计学意义。pH值(7.34±0.07与7.30±0.76,P<0.05);Lac值(4.24±1.60与2.43±1.69,P<0.05);BE值(-3.39±3.07与-6.08±3.33,P<0.05);SB值(21.94±4.30与20.01±2.95,P<0.05),剖宫产分娩组PaCO_(2)低于经阴道分娩组,PaO_(2)高于经阴道分娩组,差异有统计学意义。PaCO_(2)值(34.13±12.44与38.70±12.42,P<0.05);PaO_(2)值(26.98±7.36与23.39±5.50,P<0.05)。剖宫产分娩组与经阴道分娩组对比,新生儿出生低Apgar评分[0.9%(2/222),0.65%(1/155),χ^(2)值0.125],P>0.05,没有统计学差异。低pH值[2.25%(5/222),8.39%(13/155),χ^(2)值7.556],P<0.05,差异有统计学意义。结论经阴道分娩比剖宫产分娩的足月胎儿,更容易出现缺氧和酸血症,临床中应给予重视。

Objective To compare the blood gas value of umbilical arterial between cesarean delivery and vaginal delivery,and evaluate the influence of different delivery modes on the unbilical arterial blood gas value of newborns.Methods A retrospective analysis was performed on 37-41weeks of newborns cases(n=377),delivered at term in our hospital from January 2O21 to August 2O21,and they were divided into two groups according to the delivery mode,cesarean delivery group(n=222)and vaginal delivery group(n=155).Umbilical arterial blood gas analysis value after birth were compared between the two groups.Results The pH value,Lac value,base excess value,standard bicarbonate value of unbilical arterial blood gas of newborns delivered by cesarean were higher than those delivered by vaginal delivery group,the difference was statistically significant.pH(7.34±0.07 vs 7.30±0.76,P<0.05);Lac(4.24±1.60 vs 2.43±1.69,P<0.05);BE(-3.39±3.07 vs-6.08±3.33,P<0.05);SB(21.94±4.30 vs 20.01±2.95,P<0.05).PaCO_(2) of cesarean delivery group was lower than that of vaginal delivery group,PCO_(2) was higher than that of vaginal delivery group,the difference was statistically significant.PCO_(2)(34.13±12.44 vs 38.70±12.42,P<0.05);PaO_(2)(26.98±7.36 vs 23.39±5.50,P<0.05).The low Apgar score[0.9%(2/222)vs 0.65%(l/155),χ^(2)=0.125],P>0.05,there was no statistically significant.The low pH[2.25%(5/222),8.39%(13/155),χ^(2)=7.556],P<0.05,the difference was statistically significant.Conclusion Vaginal delivery is more prone to hypoxia and acidosis than cesarean delivery,which should be paid more attention in clinical practice.