羊水污染合并新生儿窒息动脉血乳酸及生化因子的水平变化及临床意义

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摘要目的探究与分析羊水污染合并新生儿窒息动脉血乳酸及生化因子的水平变化及临床意义。方法选取2017年3月至2021年6月抚州市妇幼保健院妇产科及新生儿科收治的120 例合并羊水污染新生儿作为研究对象，按照羊水污染程度分为Ⅰ度污染组（43 例）、Ⅱ度污染组（40 例）及Ⅲ度污染组（37 例）；其中有38 例合并存在新生儿窒息者作为窒息组，按照窒息程度的不同分为轻度窒息组（25 例）与重度窒息组（13 例），其余为无窒息组（82 例）。另选取同期出生的45 例无羊水污染新生儿作为对照组。比较不同羊水污染组及对照组的动脉血乳酸及生化因子水平；分析羊水污染程度与动脉血乳酸的相关性；比较不同羊水污染组的新生儿窒息发生率；比较不同程度窒息组新生儿出生后不同时刻的动脉血乳酸水平。结果 Ⅰ度污染组、Ⅱ度污染组、Ⅲ度污染组的动脉血乳酸值均高于对照组，Ⅱ度污染组、Ⅲ度污染组的动脉血乳酸值均高于Ⅰ度污染组，Ⅲ度污染组的动脉血乳酸值高于Ⅱ度污染组，差异有统计学意义（P＜0.05）。Pearson 相关性分析结果显示，羊水污染程度与动脉血乳酸水平成正相关（P＜0.05）。Ⅲ度污染组的窒息程度高于Ⅰ度污染组、Ⅱ度污染组，差异有统计学意义（P＜0.05）。三组新生儿出生后24 h 的动脉血乳酸值低于本组出生时、出生后6、12 h，三组新生儿出生后12 h 的动脉血乳酸值低于本组出生时、出生后6 h，三组新生儿出生后6 h 的动脉血乳酸值低于本组出生时，差异有统计学意义（P＜0.05）。重度窒息组、轻度窒息组新生儿出生时、出生后6、12、24 h 的动脉血乳酸值均高于无窒息组，重度窒息组新生儿出生时、出生后6、12、24 h 时的动脉血乳酸值均高于轻度窒息组，差异有统计学意义（P＜0.05）。结论随着羊水污染程度的增加，动脉血乳酸值也随之升高，新生儿窒息的发生率与羊水污染程度具有密切的相关性，表现为羊水污染程度越重，新生儿窒息率越高。

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	黄生才
	璩丽燕
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	何江
	艾建军
	胡海
	李海燕

关键词 ：羊水污染, 新生儿窒息, 动脉血, 乳酸, 生化因子

Abstract：Objective To explore and analyze the changes and clinical significance of arterial blood lactic acid and biochemical factors in amniotic fluid contaminated with neonatal asphyxia.Methods From March 2017 to March 2021,120 neonates with amniotic fluid pollution admitted to the Department of Obstetrics and Gynecology and Department of Neonatology in Fuzhou Maternal and Child Health Hospital were selected as the research objects,and they were divided into Ⅰdegree pollution group (43 cases) and Ⅱdegree pollution group (40 cases) and Ⅲdegree pollution group (37 cases) according to the degree of amniotic fluid pollution.A total of 38 cases with neonatal asphyxia were divided into mild asphyxia group (25 cases) and severe asphyxia group (13 cases) according to the degree of asphyxia,and the rest were non-asphyxia group (82 cases).Another 45 neonates without amniotic fluid contamination were selected as the control group.The levels of arterial blood lactic acid and biochemical factors in different amniotic fluid contaminated group and control group were compared.The correlation between the degree of amniotic fluid contamination and arterial blood lactic acid was analyzed.The incidence of neonatal asphyxia in different amniotic fluid contaminated groups was compared.The arterial blood lactic acid levels of neonates in different asphyxia groups were compared at different time after birth.Results The lactic acid values of umbilical artery blood in the Ⅰdegree pollution group,Ⅱdegree pollution group and Ⅲdegree pollution group were higher than those of the control group,the umbilical artery blood lactic acid values in the Ⅱdegree pollution group,Ⅲdegree pollution group were higher than Ⅰdegree pollution group,the lactic acid value of the umbilical artery in the Ⅲdegree pollution group was higher than that in the Ⅱdegree pollution group,and the differences were statistically significant (P＜0.05).Pearson correlation analysis showed that the degree of amniotic fluid pollution was positively correlated with arterial lactic acid level (P＜0.05).The total asphyxiation rate of the Ⅲdegree pollution group was higher than that of the Ⅰdegree pollution group and theⅡdegree pollution group,and the differences were statistically significant (P＜0.05).The arterial blood lactic acid values of the three groups 24 h after birth were lower than those at birth,6,12 h after birth,the arterial blood lactic acid values of the three groups 12 h after birth were lower than those at birth,6 h after birth,the arterial blood lactic acid values of the three groups 6 h after birth were lower than those at birth,and the differences were statistically significant (P＜0.05).The arterial blood lactic acid values of neonates in the severe asphyxia group and mild asphyxia group at birth,6,12,24 h after birth were higher than those of the non-asphyxia group,the arterial blood lactic acid values of neonates in the severe asphyxia group at birth,6,12,24 h after birth were higher than those of the mild asphyxia group,and the differences were statistically significant (P＜0.05).Conclusion As the degree of amniotic fluid pollution increases,the umbilical artery blood lactate value also increases.The incidence of neonatal asphyxia is closely related to the degree of amniotic fluid pollution.The more severe the amniotic fluid pollution,the greater the neonatal asphyxia rate.

Key words： Amniotic fluid pollution Neonatal asphyxia Umbilical artery blood Lactic acid Biochemical factors

基金资助:江西省卫生健康委员会科技计划项目（202141007）

引用本文:

黄生才；璩丽燕；黄超；何江；艾建军；胡海；李海燕. 羊水污染合并新生儿窒息动脉血乳酸及生化因子的水平变化及临床意义[J]. 中国当代医药, 2022, 29(3): 8-12.
HUANG Shengcai； QU Liyan；HUANG Chao； HE Jiang；AI Jianjun； HU Hai； LI Haiyan. Changes and clinical significance of arterial blood lactic acid and biochemical factors in amniotic fluid contaminated with neonatal asphyxia. 中国当代医药, 2022, 29(3): 8-12.

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