探讨新生儿出生时脐动脉血气分析的临床应用价值。

选取2013年10月23日至2014年5月13日在北京大学深圳医院阴道分娩的单胎活产新生儿共320例，对新生儿出生时脐动脉血气分析与Apgar评分、羊水性状和新生儿结局进行分析。

(1)Apgar评分1 min 4～7分组的pH值、PaCO₂、PaO₂、HCO₃^－、BE值的水平分别为(7.15±0.11)、(64.21±21.62) mmHg、(9.21±4.69) mmHg、(21.12±6.98) mmol/L、(－9.06±7.07) mmol/L，≥8分组分别为7.28±0.10、(43.16±15.06) mmHg、(20.38±9.21) mmHg、(19.59±5.31) mmol/L、(－6.79±4.92) mmol/L，两组比较，pH值、PaO₂及PCO₂水平，差异有统计学意义，t值分别为2.914，－2.764，2.501(P均<0.05)。(2)清亮羊水组的pH值、PaCO₂、PaO₂、HCO₃^－、BE值的水平分别(7.29±0.10)、(43.64±15.35)mmHg、(20.40±7.85)mmHg、(19.81±5.28)mmol/L、(－6.59±4.85)mmol/L，羊水Ⅰ度粪染组的分别为：(7.29±0.06)、(43.88±15.79)mmHg、(21.41±9.61)mmHg、(20.20±6.92)mmol/L、(－6.24±5.55)mmol/L，羊水Ⅱ度粪染组的分别为：(7.24±0.14)、(40.36±14.70) mmHg、(17.38±4.75) mmHg、(16.55±4.13)mmol/L、(－10.09±4.98) mmol/L。三组间比较，血气分析结果差异无统计学意义。

胎儿出生时脐动脉血气分析可作为诊断围产期窒息的客观依据，羊水Ⅰ、Ⅱ度粪染不是胎儿窘迫的征像。

To investigate the clinical application value of neonatal umbilical artery blood gas analysis.

The umbilical artery blood samples of 320 newborns, who were born in Peking University Shenzhen hospital, were obtained from October 23^rd 2013 to May 13^rd 2014. The relations between umbilical artery blood gas analysis with Apgar score, character of amniotic fluid and newborn outcome were analyzed.

(1)The level of pH value, PaCO₂, PaO₂, HCO₃^-, and base excess(BE) value in Apgar score of 4 to 7 at 1 min group were (7.15±0.11)、(64.21±21.62)mmHg, (9.21±4.69)mmHg, (21.12±6.98)mmol/L, (-9.06±7.07)mmol/L; and the datum in Apgar score ≥8 at 1 min group were (7.28±0.10), (43.16±15.06)mmHg, (20.38±9.21)mmHg, (19.59±5.31)mmol/L, (-6.79±4.92)mmol/L, respectively. There were significant differences of pH value, PaO₂ and PaCO₂ between the two groups; t=2.914, -2.764, 2.501, all P value <0.05. (2) The level of pH value, PaCO₂, PaO₂, HCO₃^-, BE value in normal amniotic fluid group were (7.29±0.10), (43.64±15.35)mmHg, (20.40±7.85)mmHg, (19.81±5.28)mmol/L, (-6.59±4.85)mmol/L; In meconium-staining amniotic fluid Ⅰ group, the datum were (7.29±0.06), (43.88±15.79)mmHg, (21.41±9.61)mmHg, (20.20±6.92)mmol/L, (-6.24±5.55)mmol/L, respectively; In meconium-staining amniotic fluid Ⅱ group, the datum were (7.24±0.14), (40.36±14.70)mmHg, (17.38±4.75)mmHg, (16.55±4.13)mmol/L, (-10.09±4.98)mmol/L, respectively. There were no significant differences of the indicators in the three groups.

Umbilical artery blood gas analysis is the objective indicator to diagnose neonatal asphyxia. Meconium-staining amniotic fluid Ⅰ and Ⅱ are not the indicators to diagnose fetal distress.