剖宫产取胎时限对脐动脉血气和Apgar 评分影响.docVIP

剖宫产取胎时限对脐动脉血气和Apgar 评分影响 　　[摘要] 目的 探讨取胎时限对脐动血气和Apgar评分的影响。 方法 选择318例妊娠足月单胎择期剖宫产手术的产妇，根据Apgar评分标准分为三组，0～3分为重度窒息组，4～7分为轻度窒息组，8～10分为对照组，比较其取胎时限、1 min Apgar评分及脐动脉血气分析和乳酸值，分析取胎时限与血气结果及Apgar评分的相关性。 结果 318例新生儿重度窒息组3例，取胎时限为（186.20±12.00）s ；轻度窒息组12例，取胎时限为（107.0±16.72）s；正常组303例，取胎时限为（45.50±8.06）s，三组取胎时限差异有统计学意义（P005）。三组脐动脉血气分析进行比较，pH值、PaCO2、PaO2、Lac及BE值间差异有统计学意义（P0.05）。取胎时限与新生儿脐动脉pH值成负相关（r=-0.491，P=0.0017）。取胎时限与新生儿脐动脉Lac值呈正相关（r=0.652，P0.001）。 结论 在行剖宫产手术时，取胎时限应尽量控制在120 s 以内，能明显减少新生儿窒息的发生。 　　[关键词] 取胎时间；脐动脉血；血气分析；乳酸；Apgar评分 　　[中图分类号] R719.8 [文献标识码] B [文章编号] 1673-9701（2018）08-0090-04 　　Effect of cesarean section time on umbilical artery blood gas and Apgar score 　　PING Yongmei DU Xiaodong ZHENG Jiangmei 　　Department of Anesthesiology，Lishui Women and Children’s Hospital in Zhejiang Province，Lishui 323000，China 　　[Abstract] Objective To investigate the effect of cesarean section delivery time on umbilical arterial blood gas and Apgar score. Methods A total of 318 puerpera undergoing selective cesarean section were enrolled in this study. Participants were divided into three groups according to Apgar grading standards： 0 to 3 as severe asphyxia group， 4 to 7 as mild asphyxia group and 8 to 10 as the control group. The delivery time， 1 min Apgar score， umbilical arterial blood gas analysis and lactic acid value were compared among the three groups. The correlation of delivery time with blood gas and Apgar score were also analyzed. Results Among 318 neonates， there were 3 cases of severe asphyxia with a delivery time of（186.20±12.00）s， 12 cases of mild asphyxia with a delivery time of（107.0±16.72）s， and 303 normal cases with a delivery time of（45.50±8.06）s， the difference was statistically significant（P0.05）. The blood gas analysis of umbilical arteries showed that the differences of pH， PaCO2， PaO2， Lac and BE value were statistically significant among three groups（P0.05）. There was a negative correlation between delivery time and pH of neonatal umbilical artery（r=-0.491， P=