[摘要] 目的 探討取胎時限對臍動血氣和Apgar評分的影響。 方法 選擇318例妊娠足月單胎擇期剖宮產(chǎn)手術(shù)的產(chǎn)婦，根據(jù)Apgar評分標準分為三組，0～3分為重度窒息組，4～7分為輕度窒息組，8～10分為對照組，比較其取胎時限、1 min Apgar評分及臍動脈血氣分析和乳酸值，分析取胎時限與血氣結(jié)果及Apgar評分的相關(guān)性。 結(jié)果 318例新生兒重度窒息組3例，取胎時限為（186.20±12.00）s ；輕度窒息組12例，取胎時限為（107.0±16.72）s；正常組303例，取胎時限為（45.50±8.06）s，三組取胎時限差異有統(tǒng)計學(xué)意義（P<005）。三組臍動脈血氣分析進行比較，pH值、PaCO2、PaO2、Lac及BE值間差異有統(tǒng)計學(xué)意義（P<0.05）。取胎時限與新生兒臍動脈pH值成負相關(guān)（r=-0.491，P=0.0017）。取胎時限與新生兒臍動脈Lac值呈正相關(guān)（r=0.652，P<0.001）。 結(jié)論 在行剖宮產(chǎn)手術(shù)時，取胎時限應(yīng)盡量控制在120 s 以內(nèi)，能明顯減少新生兒窒息的發(fā)生。
　　[關(guān)鍵詞] 取胎時間；臍動脈血；血氣分析；乳酸；Apgar評分
　　[中圖分類號] R719.8 [文獻標識碼] B [文章編號] 1673-9701（2018）08-0090-04
　　Effect of cesarean section time on umbilical artery blood gas and Apgar score
　　PING Yongmei DU Xiaodong ZHENG Jiangmei
　　Department of Anesthesiology，Lishui Women and Children’s Hospital in Zhejiang Province，Lishui 323000，China
　　[Abstract] Objective To investigate the effect of cesarean section delivery time on umbilical arterial blood gas and Apgar score. Methods A total of 318 puerpera undergoing selective cesarean section were eolled in this study. Participants were divided into three groups according to Apgar grading standards： 0 to 3 as severe asphyxia group， 4 to 7 as mild asphyxia group and 8 to 10 as the control group. The delivery time， 1 min Apgar score， umbilical arterial blood gas analysis and lactic acid value were compared among the three groups. The correlation of delivery time with blood gas and Apgar score were also analyzed. Results Among 318 neonates， there were 3 cases of severe asphyxia with a delivery time of（186.20±12.00）s， 12 cases of mild asphyxia with a delivery time of（107.0±16.72）s， and 303 normal cases with a delivery time of（45.50±8.06）s， the difference was statistically significant（P<0.05）. The blood gas analysis of umbilical arteries showed that the differences of pH， PaCO2， PaO2， Lac and BE value were statistically significant among three groups（P<0.05）. There was a negative correlation between delivery time and pH of neonatal umbilical artery（r=-0.491， P=0.0017）. There was a positive correlation between delivery time and neonatal umbilical artery Lac value（r=0.652， P<0.001）. Conclusion During cesarean section， the delivery time should be limited within 120 s as much as possible， which can significantly reduce the incidence of neonatal asphyxia.
　　[Key words] Delivery time；Umbilical artery；Blood gas analysis；Lactic acid；Apgar score
　　新生兒窒息是導(dǎo)致新生兒死亡、腦損傷的主要原因之一。新生兒窒息發(fā)病機理是低氧血癥和酸中毒引發(fā)的多臟器功能損害，大多數(shù)伴隨著神經(jīng)系統(tǒng)后遺癥[1]。早期及時預(yù)防對于減少新生兒致殘甚至死亡尤為重要[2]。在剖宮產(chǎn)手術(shù)中影響新生兒窒息因素較多，取胎時限是其中一個重要因素[3]，如發(fā)生取胎困難，將會明顯增加新生兒窒息發(fā)生率及產(chǎn)婦損傷[4]。目前國內(nèi)外關(guān)于剖宮產(chǎn)取胎時限的研究較少，且缺乏可應(yīng)用于臨床的相關(guān)指標。該研究收集2014年4月～2015年12月在我院婦產(chǎn)科出生的318例新生兒的信息，分析取胎時限對臍動脈血氣Apgar 評分的影響，并以此試探討取胎時限的范圍。

相關(guān)熱詞搜索：血氣 時限 動脈 評分 影響