脐动脉血气分析和 Apgar评分评估新生儿窒息的临床探讨

目的探讨脐动脉血气分析及Apgar评分在评估新生儿窒息中的临床意义。方法选择2012年3月～2013年3月广东省肇庆市第二人民医院分娩的84例新生儿作为研究对象，其中34例窒息新生儿为观察组．50例正常新生儿为对照组。分析两组新生儿出生时Apgar评分及脐动脉血血气分析与脏器损伤的关系，脐动脉血pH值与出生1minApgar评分的关系。结果观察组中，pH值〈7．2者占38．2％，对照组中pH值〈7．2者占16．0％，脐动脉血pH值较低的患儿，Apgar评分也较低，同时窒息的发生率较高，差异均有统计学意义（P〈0．05）。结论评估新生儿窒息不能没有血气分析的结果，脐动脉血气分析比Apgar评分对评估新生儿窒息更具客观性，两者结合，能反映胎儿宫内缺氧缺血程度，为临床正确及时诊断新生儿窒息提供可靠的科学依据。

Clinical study of umbilical artery blood gas analysis and Apgar score in evaluation of neonatal asphyxia

Objective To discuss the clinical significance of umbilical artery blood gas analysis and Apgar score in e- valuation of clinical significance in newborns with asphyxia. Methods 84 newborns from March 2012 to March 2013 in the Second People＇s Hospital of Zhaoqing City in Guangdong Province were selected as study objects, of which 34 newborns with asphyxia were as observation group, and 50 normal newborns were as control group. The relation be- tween the Apgar score at the time of birth, umbilical artery blood gas analysis and visceral injury, and the relation be- tween umbilical arterial pH and Apgar score in 1 min after birth were analyzed. Results In the asphyxia group, new- borns with pH 〈7.2 accounted for 38.2%, and in the control group, newborns with pH 〈7.2 accounted for 16.0%, um- bilical artery blood pH value was lower in children who with low Apgar score, at the same time, the rate of asphyxia neonatorum was higher, the differentese were statistically significant （P 〈 0.05） . Conclusion Assessment of neonatal asphyxia can not be done without blood gas analysis results, umbilical arterial blood gas analysis is more objective than Apgar score in the assessment of neonatal asphyxia, a combination of both can reflect the degree of fetal hypoxia is- ehemia, provide reliable scientific basis for clinical correctly and timely diagnosis of neonatal suffocation.