宫内窘迫新生儿生后早期外周血pH值与振幅整合脑电图结果的关系

张红琴, 黄璐, 陈俊, 黄为民

中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (5) : 454-457.

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中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (5) : 454-457. DOI: 10.7499/j.issn.1008-8830.2019.05.011
论著·临床研究

宫内窘迫新生儿生后早期外周血pH值与振幅整合脑电图结果的关系

  • 张红琴1, 黄璐1, 陈俊1, 黄为民2
作者信息 +

Association of peripheral blood pH early after birth with amplitude-integrated electroencephalography findings in neonates with intrauterine distress

  • ZHANG Hong-Qin1, HUANG Lu1, CHEN Jun1, HUANG Wei-Min2
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摘要

目的 探讨宫内窘迫新生儿生后早期外周血pH值与振幅整合脑电图(aEEG)结果的关系。方法 收集2017年1月至2018年5月出生的宫内窘迫新生儿的临床资料,按照生后30 min内的外周血pH值分为三组:pH ≤ 7.15组、7.15 < pH ≤ 7.25组、pH > 7.25组,每组30例。生后6 h内进行aEEG监测,各组aEEG异常率及平均脑功能监测(CFM)评分值进行比较。结果 pH ≤ 7.15组的aEEG结果异常率较pH > 7.25组显著增高(P < 0.0167);pH ≤ 7.15组aEEG CFM评分显著低于7.15 < pH ≤ 7.25组和pH > 7.25组(P < 0.05)。外周血pH值与CFM评分呈显著正相关(r=0.26,P < 0.05)。结论 宫内窘迫新生儿生后早期外周血pH值与aEEG结果有显著关系,应积极防治生后早期外周血pH值严重降低(pH ≤ 7.15)宫内窘迫新生儿的神经系统损伤。

Abstract

Objective To study the association of peripheral blood pH early after birth with amplitude-integrated electroencephalography (aEEG) findings in neonates with intrauterine distress. Methods The clinical data of the neonates with intrauterine distress who were born from January 2017 to May 2018 were collected. According to peripheral blood pH within 30 minutes after birth, these neonates were divided into 3 groups:pH ≤ 7.15, 7.15 7.25, with 30 neonates in each group. aEEG mornitoring was performed within 6 hours after birth, and the abnormal rate of aEEG findings and average cerebral function monitoring (CFM) score were compared between groups. Results The pH ≤ 7.15 group had a significantly higher abnormal rate of aEEG findings than the pH >7.25 group (P < 0.0167) and a significantly lower aEEG CFM score than the 7.15 7.25 groups (P < 0.05). Peripheral blood pH was positively correlated with the CFM score (r=0.26, P < 0.05). Conclusions Peripheral blood pH is significantly associated with aEEG findings in neonates with intrauterine distress. Active measures should be adopted for the prevention and treatment of nervous system injury in neonates with intrauterine distress who have a significant reduction in peripheral blood pH early after birth (pH ≤ 7.15).

关键词

宫内窘迫 / 振幅整合脑电图 / pH / 新生儿

Key words

Intrauterine distress / Amplitude-integrated electroencephalography / pH / Neonate

引用本文

导出引用
张红琴, 黄璐, 陈俊, 黄为民. 宫内窘迫新生儿生后早期外周血pH值与振幅整合脑电图结果的关系[J]. 中国当代儿科杂志. 2019, 21(5): 454-457 https://doi.org/10.7499/j.issn.1008-8830.2019.05.011
ZHANG Hong-Qin, HUANG Lu, CHEN Jun, HUANG Wei-Min. Association of peripheral blood pH early after birth with amplitude-integrated electroencephalography findings in neonates with intrauterine distress[J]. Chinese Journal of Contemporary Pediatrics. 2019, 21(5): 454-457 https://doi.org/10.7499/j.issn.1008-8830.2019.05.011

参考文献

[1] Bullens LM, van Runnard Heimel PJ, van der Hout-van der Jagt MB, et al. Interventions for intrauterine resuscitation in suspected fetal distress during term labor:a systematic review[J]. Obstet Gynecol Surv, 2015, 70(8):524-539.
[2] 卢伟能, 周伟. 振幅整合脑电图在新生儿监护中的应用[J]. 中国新生儿科杂志, 2011, 26(4):276-278.
[3] Burdjalov VF, Baumgart S, Spitzer AR. Cerebral function monitoring:a new scoring system for the evaluation of brain maturation in neonates[J]. Pediatrics, 2003, 112(4):855-861.
[4] 张红琴, 赵月乔. 振幅整合脑电图对宫内窘迫新生儿病情严重程度的早期评估价值[J]. 中国妇幼保健, 2018, 33(4):938-941.
[5] 乐杰, 谢幸, 林仲秋, 等. 妇产科学[M]. 第7版. 北京:人民卫生出版社, 2018:97-99.
[6] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 第4版. 北京:人民卫生出版社, 2011:307-369, 706-713, 807-816, 816-840.
[7] Hellström-Westas L, Rosén I, Svenningsen NW. Predictive value of early continuous amplitude integrated EEG recordings on outcome after severe birth asphyxia in full term infants[J]. Arch Dis Child Fetal Neonatal Ed, 1995, 72(1):F34-F38.
[8] 马存丽, 罗佳. 脐动脉血气分析及乳酸值评价围生儿的意义[J]. 医学综述, 2012, 18(18):3044-3047.
[9] Rainaldi MA, Perlman JM. Pathophysiology of birth asphyxia[J]. Clin Perinatol, 2016, 43(3):409-422.
[10] 何源, 汪珍珍, 甘斌, 等. 新生儿生后早期外周动脉血气分析评估缺氧损伤的意义[J]. 中国新生儿科杂志, 2014, 29(5):314-317.
[11] da Silva S, Hennebert N, Denis R, et al. Clinical value of a single postnatal lacate measurement after intrapartum asphyxia[J]. Acta Paediatr, 2000, 89(3):320-323.
[12] 邵勤,刁玉巧. 联合检测脐血与外周动脉血pH值评估新生儿缺氧缺血性脑损伤[J]. 山东大学学报(医学版), 2014, 52(11):38-40.
[13] 孔艳婷, 严恺, 胡黎园, 等. 生后72 h内动脉血气评估窒息新生儿脑损伤的临床价值[J].中华新生儿科杂志, 2018, 33(1):17-21.
[14] Casey BM, Goldaber KG, McIntire DD, et al. Outcomes among term infants when two-hour postnatal pH is compared with pH at delivery[J]. Am J Obstetr Gynecol, 2001, 184(3):447-450.
[15] 赵月乔, 宋小燕, 李宁, 等. 74例新生儿HIE振幅整合脑电图与Apgar评分、血气、MRI的关系[J]. 中国优生与遗传杂志, 2013, 21(5):108-110.
[16] 中国医师协会新生儿专业委员会. 新生儿窒息诊断和分度标准建议[J].中国当代儿科杂志, 2013, 15(1):1.
[17] 李坚, 蔡岳鞠, 袁媛, 等. 158例低Apgar评分新生儿外周动脉血pH的研究[J]. 广州医药, 2018, 49(1):77-79.
[18] Awal MA, Lai MM, Azemi G, et al. EEG background features that predict outcome in term neonates with hypoxic ischaemic encephalopathy:a structured review[J]. Clin Neurophysiol, 2016, 127(1):285-296.
[19] Murray DM, O'Connor CM, Ryan CA, et al. Early EEG grade and outcome at 5 years after mild neonatal hypoxic ischemic encephalopathy[J]. Pediatrics, 2016, 138(4). pii:e20160659.

基金

深圳市南山区科技创新局项目(南科研卫2016056)。


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