目的探讨正常足月顺产新生儿脐静脉血pH值能否取代脐动脉血pH值来评估新生儿健康状况,及其影响因素。方法选取2020年1—12月符合纳入标准的150例产妇及新生儿为研究对象,用GEM Premier 3000进行血气分析,采用配对t检验,进行线性相关分...目的探讨正常足月顺产新生儿脐静脉血pH值能否取代脐动脉血pH值来评估新生儿健康状况,及其影响因素。方法选取2020年1—12月符合纳入标准的150例产妇及新生儿为研究对象,用GEM Premier 3000进行血气分析,采用配对t检验,进行线性相关分析及回归分析。结果脐带动、静脉血平均pH值分别为(7.278±0.073)和(7.352±0.061),二者差异有统计学意义(P<0.001);脐带动、静血pH值在统计学上高度相关(r=0.782,P<0.05);脐带动、静脉血pH值、第二产程时长、产次、新生儿性别和需要吸氧分娩差异有统计学意义(P<0.05)。结论脐带动、静脉血pH值有显著差异,但是二者也显著相关;对于正常足月顺产新生儿,可以采集脐静脉血代替脐动脉血进行血气分析。展开更多
Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gyneco...Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.展开更多
目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐...目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐动脉血pH值及乳酸水平,并分析各单项指标及不同指标联合诊断新生儿窒息的准确率、灵敏度和特异度.结果研究组1 min Apgar评分、脐动脉血pH值和乳酸水平均高于对照组(均P<0.001).各单项指标中,1 min Apgar评分诊断准确率高于脐动脉血pH值和乳酸(均P<0.01)、灵敏度高于脐动脉血pH值(P<0.05)、特异度高于乳酸(P<0.01);联合指标中,1 min Apgar评分+脐动脉血pH值诊断准确率、灵敏度和特异度分别为80.67%、81.00%和80.50%,1 min Apgar评分+乳酸诊断准确率、灵敏度和特异度分别为80.00%、84.00%和78.00%,1 min Apgar评分+脐动脉血pH值+乳酸诊断准确率、灵敏度和特异度分别为95.00%、100.00%和92.50%,1 min Apgar评分+脐动脉血pH值+乳酸的诊断准确率、灵敏度和特异度高于1 min Apgar评分+脐动脉血pH值和1 min Apgar评分+乳酸(均P<0.001).结论在应用1 min Apgar评分与脐动脉血pH值的基础上联合乳酸检测能够提高新生儿窒息的诊断效果.展开更多
目的探讨脐动脉血pH值评价新生儿窒息及预测窒息并发症的临床意义。方法抽取2006年1月—2008年4月在我院分娩的健康产妇552例。监测其新生儿脐动脉血pH值,分析脐动脉血pH值与生后1 min Apgar评分的关系,分别对脐动脉血pH值及1 min Apga...目的探讨脐动脉血pH值评价新生儿窒息及预测窒息并发症的临床意义。方法抽取2006年1月—2008年4月在我院分娩的健康产妇552例。监测其新生儿脐动脉血pH值,分析脐动脉血pH值与生后1 min Apgar评分的关系,分别对脐动脉血pH值及1 min Apgar评分对于预测新生儿窒息并发症进行真实性的评价。结果1 min Apgar评分与脐动脉血pH值相关(χ2=278.13,P<0.05)。脐动脉血pH值对于预测窒息并发症较Apgar评分有更高的敏感度及特异度。pH值异常发生比例与HIE程度有关,随HIE程度的提高而增加(χ2=4.437,P<0.05)。结论脐动脉血pH值能客观评价新生儿出生时的状况,对监测新生儿预后、早期采取有效措施防治窒息并发症有指导意义。展开更多
文摘目的探讨正常足月顺产新生儿脐静脉血pH值能否取代脐动脉血pH值来评估新生儿健康状况,及其影响因素。方法选取2020年1—12月符合纳入标准的150例产妇及新生儿为研究对象,用GEM Premier 3000进行血气分析,采用配对t检验,进行线性相关分析及回归分析。结果脐带动、静脉血平均pH值分别为(7.278±0.073)和(7.352±0.061),二者差异有统计学意义(P<0.001);脐带动、静血pH值在统计学上高度相关(r=0.782,P<0.05);脐带动、静脉血pH值、第二产程时长、产次、新生儿性别和需要吸氧分娩差异有统计学意义(P<0.05)。结论脐带动、静脉血pH值有显著差异,但是二者也显著相关;对于正常足月顺产新生儿,可以采集脐静脉血代替脐动脉血进行血气分析。
基金the National Key Research&Development Program of China(2016YFC1000400,2018YFC1002903).
文摘Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.
文摘目的研究联合应用Apgar评分、脐动脉血pH值与乳酸诊断新生儿窒息的效果.方法选取2020年4月至2022年3月广州市番禺区妇幼保健院收治的100例新生儿窒息患儿为研究组,同期在本院分娩的200例正常新生儿为对照组,比较2组1 min Apgar评分、脐动脉血pH值及乳酸水平,并分析各单项指标及不同指标联合诊断新生儿窒息的准确率、灵敏度和特异度.结果研究组1 min Apgar评分、脐动脉血pH值和乳酸水平均高于对照组(均P<0.001).各单项指标中,1 min Apgar评分诊断准确率高于脐动脉血pH值和乳酸(均P<0.01)、灵敏度高于脐动脉血pH值(P<0.05)、特异度高于乳酸(P<0.01);联合指标中,1 min Apgar评分+脐动脉血pH值诊断准确率、灵敏度和特异度分别为80.67%、81.00%和80.50%,1 min Apgar评分+乳酸诊断准确率、灵敏度和特异度分别为80.00%、84.00%和78.00%,1 min Apgar评分+脐动脉血pH值+乳酸诊断准确率、灵敏度和特异度分别为95.00%、100.00%和92.50%,1 min Apgar评分+脐动脉血pH值+乳酸的诊断准确率、灵敏度和特异度高于1 min Apgar评分+脐动脉血pH值和1 min Apgar评分+乳酸(均P<0.001).结论在应用1 min Apgar评分与脐动脉血pH值的基础上联合乳酸检测能够提高新生儿窒息的诊断效果.
文摘目的探讨脐动脉血pH值评价新生儿窒息及预测窒息并发症的临床意义。方法抽取2006年1月—2008年4月在我院分娩的健康产妇552例。监测其新生儿脐动脉血pH值,分析脐动脉血pH值与生后1 min Apgar评分的关系,分别对脐动脉血pH值及1 min Apgar评分对于预测新生儿窒息并发症进行真实性的评价。结果1 min Apgar评分与脐动脉血pH值相关(χ2=278.13,P<0.05)。脐动脉血pH值对于预测窒息并发症较Apgar评分有更高的敏感度及特异度。pH值异常发生比例与HIE程度有关,随HIE程度的提高而增加(χ2=4.437,P<0.05)。结论脐动脉血pH值能客观评价新生儿出生时的状况,对监测新生儿预后、早期采取有效措施防治窒息并发症有指导意义。
