曾小金　陈北洋　刘琳

[摘要] 目的 探讨脐动脉血pH、羊水性状等指标联合诊断新生兒窒息并发多器官损伤的临床研究。 方法 选取我院2018年5月～2019年12月新生儿窒息并发多器官损伤患儿60例作为观察组，同期选取健康新生儿60例作为对照组，均予脐动脉血pH、羊水性状、Apgar评分联合检测，比较分析检测结果。 结果 联合检测阳性符合率为100.0%，高于单独Apgar评分阳性符合率的50.00%、单独脐动脉血pH诊断阳性符合率的58.33%和单独羊水性状诊断阳性符合率的66.67%（P<0.05）;轻度窒息伴多器官损伤发生率低于重度窒息（P<0.05）;轻度窒息患儿酸中毒、窒息危险因素发生率与重度窒息患儿比较，差异无统计学意义（P>0.05）;观察组1 min Apgar评分及pH值均低于对照组，且观察组BE值高于对照组（P<0.05）;两组5 min Apgar评分比较，差异无统计学意义（P>0.05）。 结论 脐动脉血pH、羊水性状、Apgar评分联合诊断新生儿窒息并发多器官损伤的临床效果显著，可明确患儿病情，提升诊断准确性，值得推广。

[关键词] 脐动脉血pH;羊水性状;新生儿窒息并发多器官损伤;Apgar评分

[中图分类号] R722.12          [文献标识码] B          [文章编号] 1673-9701（2020）30-0074-04

Clinical study on blood pH in the umbilical artery and the traits of amniotic fluid in combined diagnosis of neonatal asphyxia complicated with multiple organ injury

ZENG Xiaojin   CHEN Beiyang   LIU Lin

Neonatal Department， Ruijin Maternal and Child Health Hospital in Jiangxi Province， Ruijin   342500，  China

[Abstract] Objective To explore the clinical study on blood pH in the umbilical artery and the traits of amniotic fluid in combined diagnosis of neonatal asphyxia complicated with multiple organ damage. Methods A total of 60 neonates with asphyxia complicated with multiple organ injury from May 2018 to December 2019 in our hospital were selected as the observation group. At the same time， 60 healthy neonates were selected as the control group. All were given combined examination of umbilical artery blood pH， amniotic fluid， and Apgar score. The examination results were comparatively analyzed. Results The positive coincidence rate of the combined detection was 100.0%， higher than that （50.00%） of the Apgar score alone and that（58.33%） of the umbilical artery blood pH and that（66.67%） of the traits of amniotic fluid（P<0.05）. The incidence of multiple organ damage in mild asphyxia children was lower than that in children with severe asphyxia（P<0.05）. The incidence of acidosis and risk factors of asphyxia in children with mild asphyxia were lower than those with severe asphyxia， while the difference was not statistically significant（P>0.05）. The Apgar and pH in the observation group were lower than those of the control group at 1 min， and the BE value in the observation group was higher than that of the control group（P<0.05）. There was no significant difference in the 5 min Apgar score between two groups（P>0.05）. Conclusion The combined diagnosis of blood pH in the umbilical artery， traits of amniotic fluid and Apgar score for neonatal asphyxia complicated with multiple organ injury has significant clinical effect， which can clarify the condition of the child and improve the accuracy of the diagnosis， and is worthy of promotion.

[Key words] Blood pH in the umbilical artery; Traits of amniotic fluid; Neonatal asphyxia complicated with multiple organ injury; Apgar score

新生儿窒息是指由于分娩过程中的各种原因使新生儿出生后不能建立正常呼吸，是新生儿致死的主要病因，为常见的新生儿急危重症。其典型的病理特征为低氧及高碳酸血症、酸中毒，伤及心肌功能，引发心源性休克及血管扩张、主动脉舒张压下降[1]。研究发现，严重的新生儿窒息是引起新生儿残疾、死亡的主要原因之一，因窒息能导致多器官损害，严重危害新生儿健康及生命安全[2]。据统计，现在全球每年约近百万新生儿因围生期窒息及器官受损而死亡，鉴于其高发生率、高风险，临床应积极做好预防措施，首先需做好疾病的预防和鉴别。……