早期乳酸清除率对重度窒息新生儿预后的临床价值研究

摘要

Objective To study and analyze clinical value of early lactate clearance rate of severe asphyxia neonatal outcomes. Me thods Selecting newborns admitted in the hospital from January, 2012 to February, 2014.Through the clinical diagnosis, they were diagnosed with severe asphyxia, and were divided into 38 cases in excellent effect group and 14 cases in invalid group.Through lactic acid clearance rate, they were divided into high and low lactic acid clearance rate group.The index differences of the two groups were compared. Results Gestational age, sex, birth weight and hospitalization time of all patients were compared.There was no significant difference, with no significant difference (P>0.05).After treatment, there was no statistical significance of lactate level and critical cases grade(P>0.05).Before treatment, in high lactate clearance rate group, the mean value of lactate levels was (7.6 ±3.5) mmol/L, and in low lac-tate clearance rate group, the mean was (8.5 ±5.3) mmol/L .There was no statistically significance of critical cases grade (P>0.05). In high lactate clearance rate group, 1 died, and the mortality rate was 2.78%.In low lactate clearance rate group, 2 patients died, and the mortality rate was 12.50%.There was no statistical significance of the two groups ( P<0.05 ) .Conclusion Early lactate clearance rate of children can be used as an important marker of prognosis of severe neonatal asphyxia.%目的：研究分析早期乳酸清除率对重度窒息新生儿预后的临床价值。方法选取广州市白云区妇幼保健院自2012－01—2014－02间收治的52例新生儿患儿，经临床诊断，均确诊为重度窒息患儿，将所有患儿分为治疗显效组与治疗无效组，其中治疗显效组为38例，治疗无效组为14例。再以乳酸清除率为依据，分为高乳酸清除率组与低乳酸清除率组，对比两组上述指标差异。结果所有组别患儿在胎龄、性别、入院治疗时间以及出生体重对比，差异无统计学意义（ P＞0．05）。治疗后经测定存活组患儿，乳酸水平、危重病例评分差异无统计学意义（ P＞0．05）。治疗前高乳酸清除率组，动脉血乳酸水平测定平均值为（7．6±3．5）mmol／L，低乳酸清除率组平均值为（8．5±5．3）mmol／L，危重病例评分差异无统计学意义（P＞0．05）。高乳酸清除率组死亡1例，死亡率为2．78％，低乳酸清除率组死亡2例，死亡率为12．50％，差异有统计学意义（ P＜0．05）。结论患儿早期乳酸清除率，可作为判断重度窒息新生儿预后的一个重要指标。