|
|
Changes and clinical significance of arterial blood lactic acid and biochemical factors in amniotic fluid contaminated with neonatal asphyxia |
HUANG Shengcai1 QU Liyan2 HUANG Chao1 HE Jiang3 AI Jianjun1 HU Hai1 LI Haiyan4 |
1.Department of Neonatology,Fuzhou Maternal and Child Health Hospital,Jiangxi Province,Fuzhou 344100;China;
2.Department of Obstetrics,Fuzhou Maternal and Child Health Hospital,Jiangxi Province,Fuzhou 344100;China;
3.Department of Laboratory,Fuzhou Maternal and Child Health Hospital,Jiangxi Province,Fuzhou 344100;China;
4.Department of Internal Medicine,Fuzhou Maternal and Child Health Hospital,Jiangxi Province,Fuzhou 344100;China |
|
|
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.
|
|
|
|
|
[1] |
卢国辉,林志慧,黄景泉.分析羊水污染、宫内胎儿窘迫与新生儿缺血缺氧性脑病的关联性[J].中国临床实用医学,2019,10(5):25-28.
|
[2] |
曹春娟,吴素慧.脐动脉血乳酸浓度在新生儿酸中毒及窒息评估中的价值[J].中国计划生育和妇产科,2019,11(11):68-92.
|
[3] |
罗海平,覃肇源,陈泽林,等.新生儿窒息后血乳酸和动脉血气变化对评估器官损害程度的临床价值[J].中外医学研究,2020,18(7):66-68.
|
[4] |
中华医学会围产医学分会新生儿复苏学组.新生儿窒息诊断的专家共识[J].中华围产医学杂志,2016,19(1):3-6.
|
[5] |
American College of Obstetricians and Gynecologists.Committee Opinion No 689:Delivery of a Newborn With Meconium-Stained Amniotic Fluid[J].Obstet Gynecol,2017,129(3):e33-e34.
|
[6] |
曹立萍,李彩霞,王冬霞,等.血乳酸和心肌酶变化在胎儿宫内窘迫新生儿中的临床意义[J].现代生物医学进展,2019,19(20):3916-3917.
|
[7] |
焦丽杰,朱明哲.动脉血乳酸和乳酸清除率在新生儿窒息严重程度评估及预后判断中的价值分析[J].临床合理用药杂志,2019,12(2):140-141.
|
[8] |
眭颖,陈烨.动脉血乳酸联合血糖监测在新生儿窒息诊断中的意义[J].浙江临床医学,2019,21(12):1679-1680.
|
[9] |
张晓婷,陈裕萍,彭娟丽.窒息新生儿动脉血乳酸、血糖的监测和观察[J].中国医学工程,2018,26(7):16-20.
|
[10] |
花少栋,岳丽琴,程黎明,等.新生儿窒息时脐带动脉血气中乳酸和碱剩余值的阈值研究[J].中国小儿急救医学,2019,26(12):901-906.
|
[11] |
罗厚江,汪瑞,陈茹茹,等.动脉血乳酸水平与早期乳酸清除率在新生儿窒息严重程度判断及预后评估中的价值[J].中华全科医学,2019,17(9):23-24.
|
[12] |
曾小金.脐动脉血pH、羊水性状等指标联合诊断新生儿窒息并发多器官损伤的临床研究[J].中国现代医生,2020,58(30):74-77.
|
[13] |
张珊,董文斌.窒息新生儿血NGAL、CysC 和尿微量蛋白的水平变化及临床意义[J].中国现代医学杂志,2018,28(23):20-21.
|
[14] |
白波,陈波,李广洪,等.新生儿窒息复苏后发生持续肺动脉高压的危险因素探讨[J].中国妇幼保健,2019,34(2):45-46.
|
[15] |
聂华,陈峪,刘丽平.羊水Ⅲ度粪染MAS 新生儿脐动脉血气、新生儿血清炎症因子的变化及其意义[J].重庆医学,2018,47(6):110-111.
|
[16] |
王莹,缪珀,任静,等.新生儿窒息后血褪黑素和应激因子变化的临床研究[J].临床儿科杂志,2018,36(3):678-679.
|
[17] |
陈云云,陶瑞雪,王丽娟.子痫前期对妊娠期肝内胆汁淤积症患者血液生化指标及妊娠结局的影响[J].海南医学院学报,2019,25(13):550-551.
|
[18] |
蒋映雪,丁晓静,王孝君,等.原发性羊水过少与妊娠并发症的相关性及对妊娠结局的影响[J].中国妇幼健康,2018,33(1):99-100.
|
[19] |
罗敏,叶丽娜,何春梅.胎心监护重度变异减速、脐血乳酸监测、血气分析联合检测对新生儿窒息预后评估[J].中国医药科学,2021,11(14):85-88,122.
|
|
|
|