阴道分娩与剖宫产的正常足月新生儿脐动脉血乳酸值的比较

Umbilical Artery Lactate Levels of Normes Full-term Neonates by Vaginal Delivery Compare with Those of Cesarean Section

目的 :探讨阴道分娩与剖宫产的足月正常新生儿脐动脉血乳酸值间的差异 ,及阴道分娩新生儿脐动脉血乳酸值与产妇第二产程时间的相关性。方法 :5 6例阴道分娩和 6 2例剖宫产的足月正常新生儿出生后立即取 2ml脐动脉血行乳酸检测。并对阴道分娩新生儿脐动脉血乳酸值与第二产程时间长短的相关性进行分析。结果 :阴道分娩组的脐动脉血乳酸水平明显高于剖宫产组 (P <0 0 1) ;但阴道分娩中第二产程≤ 45分钟 (10例 ) ,脐动脉血乳酸水平低于剖宫产组 (P <0 0 5 ) ;第二产程≤ 1小时 (2 8例 ) ,乳酸水平与剖宫产组比较 ,差异无显著性 (P >0 0 5 ) ;而第二产程 >1小时 (2 8例 ) ,乳酸水平高于剖宫产组 (P <0 0 5 )。阴道分娩新生儿乳酸水平与第二产程时间呈密切正相关 (P <0 0 1)。结论 :阴道分娩第二产程 <1小时与剖宫产比较新生儿乳酸值无差异 ;而当第二产程 >1小时 ,则使新生儿乳酸值增高。故对第二产程长应重视 ,并予积极处理。

Objective:To analyse the difference of normal full-term neonatal umbilical artery lactate levels in the vaginal delivery and the cesarean section , and the correlation between the neonatal umbilical artery lactate levels of vaginal delivery and the lasting time of the second stage of labor. Methods:Normal neonatal umbilical artery lactate levels were measured in the vaginal delivery group (n=56) and the cesarean section group (n=62). The correlation between neonatal umbilical artery lactate levels in the vaginal delivery group (n=56) and the lasting time of the second stage of labor was analyzed. Results:Umbilical artery lactate levels of the vaginal delivery group were significantly higher than those of the cesarean section group (P<0.01). But umbilical artery lactate levels in the vaginal delivery group with the second stage ≤45 min(n=10)were significantly lower than those of the cesarean section group(P<0.05). There was no significant difference in lactate levels between the second stage of labor ≤1h (n=28) and the cesarean section group (P>0.05). Umbilical artery lactate levels in the neonate with the second stage>1h (n=28) were significantly higher than those of the cesarean section group (P<0.05). There was a positive correlation between neonatal lactate levels of vaginal delivery and the lasting time of the second stage of labor (P<0.01).Conclusions:There was no significant difference in umbilical artery lactate levels between the vaginal delivery with the second stage of labor<1h and the cesarean section group. When the second stage of labor>1h , the neonatal lactate levels were increased. So we should pay a attention to the prolonged second stage of labor, and treat it actively.