新生儿窒息生后早期血气、电解质与脑电图相关性分析

目的:探讨新生儿窒息生后早期血气、电解质与新生儿脑电图的相关性。方法:对75例新生儿窒息患儿于生后1h内进行动脉血气、电解质测定,12～48h进行脑电图检查。结果:75例窒息儿其中轻度窒息56例,重度窒息19例,并据动脉血气异常与否分为血气正常型及血气异常型。脑电图异常率分别为:轻度窒息组46.4%,重度窒息组52.6%,脑电图重度异常发生率两组分别为:3.6%及26.3%;血气正常型脑电图异常率为:42.1%,血气异常型54.1%,脑电图重度异常发生率分别为:2.6%及16.2%。研究表明出生早期有动脉血气异常的窒息儿,脑电图重度异常率高于血气正常的窒息儿(P<0.05),同时重度窒息组脑电图重度异常率也高于轻度窒息组(P<0.05),差异有统计学意义。电解质及血色素值异常与脑电图异常率的差异无统计学意义,但电解质异常的窒息儿脑电图异常率也达到了55%,其中包括重度异常1例,因而也不能忽视电解质异常所造成的影响,结论:提示出生早期动脉血气异常的窒息儿与重度窒息儿脑血流再灌注损伤更明显,预后不良的可能性会增加,更应注意脑损伤的预防与修复。同时提示早期新生儿血气可作为判断新生儿窒息有无及程度、预后的指标之一。总之积极纠正血气、电解质,使之尽快达到正常范围在窒息复苏中是很重要的。

An analysis of the correlation of arterial blood gases, and electrolytes with electroencephalogram on forepart asphyxia of the newborn

Objective:To elucidate the relativity of arterial blood gases and electrolytes with electroencephalogram on forepart asphyxia of the newborn.Methods:Blood samples were obtained from 75 forepart asphyxia of the newborns who were less than one hour old in our hospital.Arterial blood gases and electrolytes were measured toward the blood of the newborns.After that,electroencephalogram was done to them in 12~48 hours.Results:Among the 75 patients,56 of them were in mild asphyxia group,19 of them were in severe asphyxia group.46.4% of mild asphyxia group had abnormal electroencephalogram 52.6% of severe asphyxia group had abnormal electroencephalogram.The percent of severe abnormal electroencephalogram of the two groups are 3.6% and 26.3% (P<0.05).Asphyxia newborns was further divided in two types: normal and abnormal in arterial blood gases.42.1% of asphyxia group which arterial blood gases are normal had abnormal electroencephalogram,54.1% of asphyxia group which arterial blood gases are abnormal had abnormal electroencephalogram.The percent of severe abnormal electroencephalogram of the two types are 2.6% and 16.2% (P<0.05).55.0% of asphyxia group which electrolytes are abnormal had abnormal electroencephalogram.But this abnormal seems having no relation with electroencephalogram (P>0.05).Conclusion:The results indicated that abnormal arterial blood gases in forepart asphyxia of the newborns are associated with severe abnormal electroencephalogramFurther evidence showed that arterial blood gases are very important indications in asphyxia of the newborns.The author propose that it is necessary to monitor the arterial blood gases and electrolytes in forepart asphyxia of the newborn,and it is important to make them normal as early as possible.