Neonatal Umbilical Arterial Blood Gas Analysis For Judging The Clinical Value Of Neonatal Asphyxia And Prognosis

BackgroundNeonatal asphyxia is extremely common in obstetrics.Its essence is traumatic hypoxemia and metabolic acidosis,which seriously damage the life and health of newborns.Accurate prediction of neonatal asphyxia is of great significance for guiding clinical interventions.Umbilical artery blood gas status can objectively reflect the blood gas condition of newborns.Many foreign research data shows that umbilical artery blood gas is closely related to neonatal asphyxia.The United States has adopted umbilical artery blood gas analysis as a new standard for the diagnosis of neonatal asphyxia,and some studies suggest that neonatal umbilical artery Blood gas analysis can predict the prognosis of neonatal asphyxia.However,there are few relevant studies in my country,and umbilical artery blood gas analysis has not been widely used in the evaluation of neonatal asphyxia.This study analyzes the clinical value of neonatal umbilical artery blood gas analysis for judging neonatal asphyxia and prognosis,and hopes to provide a reference for obstetrics to prevent neonatal asphyxia.ObjectiveBy analyzing the relationship between neonatal umbilical arterial blood gas index and neonatal asphyxia,acidosis,neonatal hypoxic ischemic encephalopathy（HIE）,and multiple organ dysfunction,the neonatal umbilical arterial blood gas analysis was used to determine neonatal asphyxia.And the clinical value of prognosis.Research methodBased on the existing clinical diagnostic criteria of neonatal asphyxia,7053single-fetal and full-term newborns who were born live in the obstetrics department of our hospital from October 2017 to December 2020 were selected as the research object.According to the existing obstetric clinical diagnostic criteria for neonatal asphyxia,according to the Apgar score,they were classified as normal without asphyxia Group 8-10 points（normal group,6689 cases）,mild asphyxia group 4-7points（mild group,321 cases）,severe asphyxia group 0-3 points（severe group,43cases）.There was no statistically significant difference in the baseline data of the three groups of newborns（P>0.05）,and they were comparable.After the newborn is born and before the first cry,collect 0.1ml of umbilical artery blood,use the American Nova blood gas analyzer to detect the umbilical artery blood gas condition,including p H（p H）,PO2（partial pressure of oxygen）,Pa CO2（carbon dioxide）Pressure),SO2（oxygen saturation）,HCO3-（bicarbonate）,BE（base excess）.Analyze the relationship between neonatal umbilical artery blood gas and asphyxia（Apgar score）,neonatal acidosis,neonatal hypoxic ischemic encephalopathy（HIE）,multiple organ dysfunction,and analyze the relationship between neonatal p H and HIE,multiple organs The relationship between dysfunction,comprehensively judge the clinical value of neonatal umbilical artery blood gas in predicting neonatal asphyxia and prognosis.Statistical analysis was performed with SPSS 23.0 software,and the measurement data were expressed by（χ?±s）.All data were tested by normality,the paired t test conformed to the normal distribution,and the non-parametric rank was used for the non-normal distribution.For the test,the count data were analyzed byχ²test,and the difference was statistically significant at P<0.05.Correlation study was used to analyze the correlation between neonatal umbilical arterial blood gas and asphyxia and prognosis（acidosis,HIE）,and the relationship between Pearson-related descriptive variables and scatter plots in accordance with the two-variable normal distribution;The relationship between the variables described by the Spearman rank correlation is consistent with the bivariate normal distribution.Result（1）The p H values,PO₂,Pa CO₂,SO₂,HCO3-,and BE of the umbilical artery of the three groups of neonates were significantly different（P<0.05）.The comparison of the indexes of any two groups of newborns was statistically significant（P<0.05）.Among them,the comparison of p H value,PO₂,SO₂,HCO3-and BE was normal group>mild group>severe group,and Pa CO₂ comparison was normal group<mild group<severity group.Pearson bivariate analysis showed that p H,PO₂,SO₂,HCO3-,BE were positively correlated with Apgar score,and Pa CO₂ was negatively correlated with Apgar score.（2）The incidence of acidosis in the three groups was the normal group<mild group<severe group,the difference was significant（P<0.05）,and the difference between the two groups was statistically significant（P<0.05）.Spearman correlation analysis showed a negative correlation between acidosis and Apgar score.（3）The incidence of HIE and multiple organ dysfunction in the three groups was normal in the normal group<mild group<severe group,the difference was significant（P<0.05）,and the difference between the two groups was statistically significant（P<0.05）.Spearman correlation analysis showed that the incidence of HIE and multiple organ dysfunction was negatively correlated with Apgar score.（4）The incidence of HIE and multiple organ dysfunction in the p H<7.2 group was higher than that in the p H≥7.2 group,and the difference was statistically significant（P<0.05）.Spearman correlation analysis showed that p H value was closely related to HIE and multiple organ dysfunction.With the decrease of p H value,the incidence of HIE and multiple organ dysfunction increased.ConclusionUmbilical artery blood gas analysis can help diagnose neonatal asphyxia and its severity,and can predict the prognosis of neonatal asphyxia,and can provide parameter support for obstetric prevention and treatment of neonatal asphyxia.