新生儿窒息后酸中毒与多脏器功能损伤相关性分析(1)
【摘要】 目的：分析新生儿窒息后酸中毒与多脏器功能损伤的相关性，旨在获得指向性的指标为复苏后治疗提供有效指导。方法：选取2016年1月-2020年2月本院新生儿科收治的84例新生儿窒息患儿。比较不同pH、BE值患儿脏器损伤情况;分析pH、BE值与脏器损伤的相关性。结果：pH与BE值越低，患儿脏器损伤、重度脏器损伤数目及死亡例数越高(P<0.05)，其中pH<6.95、BE<-25 mmol/L时，患儿死亡率最高。新生儿窒息后pH、BE值与患儿脏器损伤、重度脏器损伤数目及死亡例数均呈负相关(P<0.05)。结论：新生儿窒息后酸中毒程度与多脏器功能损伤密切相关，影响患儿的预后。酸中毒越严重，脏器损伤数目越多，其中pH<6.95、BE<-25 mmol/L时提示患儿死亡率最高，预后极差。
【关键词】 新生儿窒息 酸中毒 多脏器功能损伤
Correlation Analysis between Acidosis and Multi-organ Functional Injury after Neonatal Asphyxia/LIN Guangyu， YANG Jie， DENG Qiumin， YE Xiaoxia， LI Xiaolan. //Medical Innovation of China， 2020， 17(15)： 0-037
[Abstract] Objective： To analyze the correlation between acidosis and multi-organ functional injury after neonatal asphyxia， in order to obtain directional indicators to provide effective guidance for post-resuscitation treatment. Method： A total of 84 cases of neonatal asphyxia admitted to the department of neonatology in our hospital from January 2016 to February 2020 were selected. The organ damage of children with different pH value and BE value were compared. The correlation between pH， BE value and organ damage was analyzed. Result： The lower the pH and BE value， the higher the number of organ injury， severe organ injury and death cases (P<0.05).When pH<6.95 and BE<-25 mmol/L， the mortality rate was highest. After neonatal asphyxia， pH and BE were negatively correlated with the number of organ injuries， severe organ injuries and death cases (P<0.05). Conclusion： The degree of acidosis after neonatal asphyxia is closely related to the multi-organ functional injury， which affects the prognosis of children. The more severe the acidosis， the more the number of organ injuries. When pH<6.95 and BE<-25 mmol/L， the mortality rate is the highest and the prognosis is extremely poor.
[Key words] Neonatal asphyxia Acidosis Multi-organ functional injury
First-author’s address： Dianbai District People’s Hospital of Maoming， Maoming 525400， China
doi：10.3969/j.issn.1674-4985.2020.15.009
新生兒窒息(neonatal asphyxia)是临床产科常见的危急症，产程中各种因素导致的新生儿出生1 min后出现的无自主呼吸、呼吸抑制，进而产生进行性的低氧血症、酸中毒等，影响患儿的新陈代谢，损伤脏器，诱发系统功能障碍[1-2]。目前，主要利用新生儿Apgar评分、脐动脉血气分析等指标对患儿的窒息程度及预后进行评估，但是很少利用动脉血气分析评估酸中毒对脏器损伤的影响[3-4]。本文旨在通过对新生儿窒息后酸中毒与多脏器损伤相关性分析，获得指向性的指标，为复苏后的治疗，减轻对患儿脏器的损伤提供有效指导，现报道如下。
1 资料与方法
1.1 一般资料 选取2016年1月-2020年2月本院新生儿科84例新生儿窒息患儿作为研究对象。纳入标准：出生后1 min Apgar评分≤7分;出生5 min后仍旧未建立有效的自主呼吸，且Apgar评分≤7分，其中轻度窒息为Apgar评分4～7分，重度窒息为Apgar评分≤3分。排除标准：新生儿败血症、先天性心脏病及硬肿症;合并出血性疾病及消化系统疾病(坏死性小肠结肠炎);先天性肾病引起的酸中毒;临床资料不全。所有患儿家属均知情同意并签署知情同意书，本研究已经医院伦理委员会批准。, http://www.100md.com(林广玉 杨婕 邓秋敏 叶小霞 李晓兰)
【关键词】 新生儿窒息 酸中毒 多脏器功能损伤
Correlation Analysis between Acidosis and Multi-organ Functional Injury after Neonatal Asphyxia/LIN Guangyu， YANG Jie， DENG Qiumin， YE Xiaoxia， LI Xiaolan. //Medical Innovation of China， 2020， 17(15)： 0-037
[Abstract] Objective： To analyze the correlation between acidosis and multi-organ functional injury after neonatal asphyxia， in order to obtain directional indicators to provide effective guidance for post-resuscitation treatment. Method： A total of 84 cases of neonatal asphyxia admitted to the department of neonatology in our hospital from January 2016 to February 2020 were selected. The organ damage of children with different pH value and BE value were compared. The correlation between pH， BE value and organ damage was analyzed. Result： The lower the pH and BE value， the higher the number of organ injury， severe organ injury and death cases (P<0.05).When pH<6.95 and BE<-25 mmol/L， the mortality rate was highest. After neonatal asphyxia， pH and BE were negatively correlated with the number of organ injuries， severe organ injuries and death cases (P<0.05). Conclusion： The degree of acidosis after neonatal asphyxia is closely related to the multi-organ functional injury， which affects the prognosis of children. The more severe the acidosis， the more the number of organ injuries. When pH<6.95 and BE<-25 mmol/L， the mortality rate is the highest and the prognosis is extremely poor.
[Key words] Neonatal asphyxia Acidosis Multi-organ functional injury
First-author’s address： Dianbai District People’s Hospital of Maoming， Maoming 525400， China
doi：10.3969/j.issn.1674-4985.2020.15.009
新生兒窒息(neonatal asphyxia)是临床产科常见的危急症，产程中各种因素导致的新生儿出生1 min后出现的无自主呼吸、呼吸抑制，进而产生进行性的低氧血症、酸中毒等，影响患儿的新陈代谢，损伤脏器，诱发系统功能障碍[1-2]。目前，主要利用新生儿Apgar评分、脐动脉血气分析等指标对患儿的窒息程度及预后进行评估，但是很少利用动脉血气分析评估酸中毒对脏器损伤的影响[3-4]。本文旨在通过对新生儿窒息后酸中毒与多脏器损伤相关性分析，获得指向性的指标，为复苏后的治疗，减轻对患儿脏器的损伤提供有效指导，现报道如下。
1 资料与方法
1.1 一般资料 选取2016年1月-2020年2月本院新生儿科84例新生儿窒息患儿作为研究对象。纳入标准：出生后1 min Apgar评分≤7分;出生5 min后仍旧未建立有效的自主呼吸，且Apgar评分≤7分，其中轻度窒息为Apgar评分4～7分，重度窒息为Apgar评分≤3分。排除标准：新生儿败血症、先天性心脏病及硬肿症;合并出血性疾病及消化系统疾病(坏死性小肠结肠炎);先天性肾病引起的酸中毒;临床资料不全。所有患儿家属均知情同意并签署知情同意书，本研究已经医院伦理委员会批准。, http://www.100md.com(林广玉 杨婕 邓秋敏 叶小霞 李晓兰)
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