The Clinical Significance Of Apgar Score And Arterial Blood Gas Analysis In Neonatal Organ Function Injury

Background : in order to reduce the morbidity and mortality of organ function injury after neonatal asphyxia,this study intends to explore the value and clinical significance of Apgar score and umbilical artery blood gas analysis in organ function injury of neonates,so as to provide evidence-based evidence for early detection and treatment.Methods:Neonates born in the obstetrics department of our hospital from June 2017 to October 2018,who were lack of vitality after birth and transferred to NICU with complete clinical data after resuscitation were selected: 40 cases with 0-3 minute Apgar score and 40 cases with 4-7 minute Apgar score.Umbilical artery blood was extracted immediately after birth for blood gas analysis and detection,and basic information and data of prenatal and labor were collected.Apgar score at 1 minute and 5-minute after birth,blood routine examination within 24 hours,blood coagulation analysis,biochemical indexes and follow-up imaging results,and a series of examination results were recorded.The clinical data were statistically processed.Results:(1)5-minute after birth,Agpar score <7,umbilical artery blood gas analysis PH<7.20,BE <-7 and premature delivery were independent risk factors for organ function injury after neonatal asphyxia.The above risk factors were negatively correlated with the occurrence of organ function injury in neonates,and the difference was statistically significant(P < 0.05).(2)The number of neonatal organ injuries was 2.86±1.97 when 5min Apgar score<7,which was higher than that when Apgar score was 8-10(1.05 1.31),and the difference was statistically significant(P < 0.05).(3)when the PH≥7.2,the number of involved organs was 0.91±0.87,and when the PH< 7.2,the number of involved organs was 3.46±1.90,the difference was statistically significant,(P < 0.05).(4)when BE >-7,the number of involved organs is 1.30±1.68;When BE ≤-7,the number of involved organs was 2.75±1.85,and the difference was statistically significant(P < 0.05).(5)The critical values of Apgar score,PH value and BE value for the diagnosis of neonatal organ function impairment are 7.5,7.27 and-5.5,and their AUC are 0.837,0.895 and 0.856,respectively.Conclusion:(1)5-minute Agpar score ≤7,umbilical artery blood gas analysis PH < 7.20,BE ≤-7 and premature delivery were independent risk factors for organ function injury after neonatal asphyxia.(2)5-minute Apgar score,PH value and BE value have certain predictive significance for the determination of neonatal organ function injury.The sensitivity and specificity of Apgar score ≤7.5,PH≤7.27,BE≤-5.5 have certain predictive value on organ function injury after neonatal asphyxia.Combined with the above three indicators can more accurately determine the organ function injury after neonatal asphyxia.