产前电子胎心率变化(EFM)与产后新生儿酸血症的相关性研究
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摘要
目的研究产前电子胎心率变化(EFM)与产后新生儿酸血症的相关性。方法选取2017年10月至2018年3月深圳市蛇口人民医院诊治的160例胎儿电子监护图形异常的产妇作为研究组,以及胎儿电子监护图形正常的产妇160例作为对照组进行研究。观察两组产妇产前电子胎心率变化(EFM)、产后新生儿酸血症发生情况、新生儿阿氏评分、新生儿脐动脉血气指标比较以及产妇临床资料情况对比。结果研究组产妇在年龄、孕周以及新生儿重量方面与对照组产妇差异无统计学意义(P>0.05);对照组产妇产出的新生儿阿氏评分明显高于研究组产妇的新生儿,差异具有统计学意义(P<0.05);对照组新生儿其动脉血气指标中pH值、BE、PO_2以及SB水平显著高于研究组新生儿(P<0.05),而PCO_2水平明显低于研究组新生儿,差异具有统计学意义(P<0.05);对照组新生儿胎心率评分(FHR评分)明显高于研究组新生儿,差异具有统计学意义(P<0.05);对照组患者患者剖宫产以及胎吸助产比例明显低于研究组患者,差异具有统计学意义(P<0.05),自然分娩比例显著高于研究组者,差异具有统计学意义(P<0.05)。结论胎儿电子监护图形异常的产妇其胎心率评分明显较高,对后期治疗提供数据,值得在临床上进一步采用和推广。
Objective To study the correlation between changes in prenatal electronic fetal monitoring(EFM) and postpartum neonatal acidosis. Methods 160 parturients with abnormal EFM in our hospital fromOctober 2017 to March 2018 were selected as the study group and 160 pregnant women with normal EFM as the control group. The changes in the EFM, the occurrence of neonatal acidemia, newbornApgar score, neonatal umbilical artery blood gas index and maternal clinical datain the two groupswere observed and compared. Results There was no statistically significant difference between the two groups in the age, pregnancy week and the weight of newborn(P>0.05). The newborn Apgar scores in the control group were significantly higher than those in the study group, with statistically significant difference(P< 0.05). The levels of pH, BE, PO_2 and SB in the blood gas index of the control group was significantly higher than those in the study group(P<0.05), while the level of PCO_2 was significantly lower than that of the study group, all with statistically significant differences(P<0.05).The neonatal fetal heart rate score(FHR score) in the control group was significantly higher than that of the study group, with statistically significant difference(P<0.05). The proportion of caesarean section and fetal suction in the control group was significantly lower than that of the study group(P<0.05), and the ratio of natural birth ratio was significantly lower thanthat of the study group, all with statistically significant differences(P<0.05). Conclusions The FHR score of pregnant women with abnormal EFM is obviously higher, which is of significance for the treatment and can be used and popularized in clinical practice.
Objective To study the correlation between changes in prenatal electronic fetal monitoring(EFM) and postpartum neonatal acidosis. Methods 160 parturients with abnormal EFM in our hospital fromOctober 2017 to March 2018 were selected as the study group and 160 pregnant women with normal EFM as the control group. The changes in the EFM, the occurrence of neonatal acidemia, newbornApgar score, neonatal umbilical artery blood gas index and maternal clinical datain the two groupswere observed and compared. Results There was no statistically significant difference between the two groups in the age, pregnancy week and the weight of newborn(P>0.05). The newborn Apgar scores in the control group were significantly higher than those in the study group, with statistically significant difference(P< 0.05). The levels of pH, BE, PO_2 and SB in the blood gas index of the control group was significantly higher than those in the study group(P<0.05), while the level of PCO_2 was significantly lower than that of the study group, all with statistically significant differences(P<0.05).The neonatal fetal heart rate score(FHR score) in the control group was significantly higher than that of the study group, with statistically significant difference(P<0.05). The proportion of caesarean section and fetal suction in the control group was significantly lower than that of the study group(P<0.05), and the ratio of natural birth ratio was significantly lower thanthat of the study group, all with statistically significant differences(P<0.05). Conclusions The FHR score of pregnant women with abnormal EFM is obviously higher, which is of significance for the treatment and can be used and popularized in clinical practice.
引文
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[17] 刘玉鹏,李溪远,丁圆,等.琥珀酰辅酶A连接酶缺陷导致继发性甲基丙二酸尿症四例的临床与实验室研究[J].中华儿科杂志,2016,54(5):365-369.
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[19] 刘莉,韩宇博,邹国良,等.射血分数保留的心力衰竭患者中医证型与游离脂肪酸和心型脂肪酸结合蛋白的相关性研究[J].辽宁中医杂志,2016,11(12):2555-2558.
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[22] 周兴生,林文弢,何晓龙,等.男子足球运动员YO-YO测试与运动后血乳酸、心率变化相关性的分析[J].广州体育学院学报,2017,37(4):85-89.
[23] 徐晓燕,翟小琳,吕涛,等.不同血液病患者EB病毒和人巨细胞病毒核酸检测阳性率与年龄的相关性研究[J].中华医院感染学杂志,2017,27(7):1500-1503.
[24] 刘玉鹏,李溪远,丁圆,等.琥珀酰辅酶A连接酶缺陷导致继发性甲基丙二酸尿症四例的临床与实验室研究[J].中华儿科杂志,2016,54(5):365-369.
[25] 王娟,许兵兵,曾金祥,等.车前子醇提物与毛蕊花糖苷对实验性高尿酸血症小鼠的比较研究[J].中国新药与临床杂志,2016,11(9):653-659.
[2] 何忠明,蒋雪龙,达霹雳情,等.维吾尔族与汉族阻塞性睡眠呼吸暂停低通气综合征患者日间高碳酸血症的特点及相关因素[J].中华医学杂志,2016,96(44):3563-3567.
[3] Khol-Parisini A,Humer E,Harder H,et al.Metabolic responses,performance,and reticuloruminal pH of early-lactating cows fed concentrates treated with lactic acid,with or without inorganic phosphorus supplementation[J].Journal of Dairy Science,2016,99(8):6237-6250.
[4] 吴丽群,王美霞,姚锐,等.宫内感染与胎母输血综合征的细胞因子变化及围产儿预后[J].实用医学杂志,2017,33(18):3085-3088.
[5] 李璃,马定远,孙云,等.应用Ion Torrent测序技术检测一个甲基丙二酸血症家系的致病突变暨产前诊断[J].中华医学遗传学杂志,2016,33(2):181-185.
[6] Macdonald TM,Hui L,Tong S,et al.Reduced growth velocity across the third trimester is associated with placental insufficiency in fetuses born at a normal birthweight:A prospective cohort study[J].Bmc Medicine,2017,15(1):164-165.
[7] 程静,马乐,苏春芳.动脉血乳酸及早期乳酸清除率与老年COPD合并呼吸衰竭患者预后的相关性[J].实用医学杂志,2016,32(6):952-954.
[8] 谢波波,罗静思,范歆,等.一个单纯性甲基丙二酸血症家系中MUT基因两个新突变的鉴定[J].中华医学遗传学杂志,2016,33(2):135-139.
[9] Lu Z,Yao L,Jiang Z,et al.Acidic pH and short-chain fatty acids activate Na +,transport but differentially modulate expression of Na + /H +,exchanger isoforms 1,2,and 3 in omasal epithelium[J].Journal of Dairy Science,2016,99(1):733-745.
[10] 张玲,史梁,张杰.血清同型半胱氨酸、维生素B 12和叶酸水平与妊娠期亚临床甲状腺功能减退的相关性[J].重庆医学,2016,45(27):3785-3787.
[11] 于丽琴,马星,杨蓉佳.血乳酸水平和乳酸清除率与急诊病情分层及预后的相关性分析[J].中华危重病急救医学,2016,28(4):339-343.
[12] 刘燕,张军,蒲强红,等.瑞舒伐他汀减轻ApoE^-/-小鼠动脉硬化形成与ST6Gal-Ⅰ表达相关性研究[J].中国药理学通报,2016,32(4):525-530.
[13] 申炳俊,金丽虹,张佳佳,等.对-香豆酸与人血清白蛋白相互作用的荧光和表面增强拉曼光谱研究[J].发光学报,2016,37(10):1259-1266.
[14] 涂芊茜,赵宁,徐淼,等.急性心肌梗死患者血清心型脂肪酸结合蛋白水平与心功能参数的相关性[J].中国老年学杂志,2016,36(20):5037-5039.
[15] 罗辉遇,李奕华,胡燕怡,等.肺源性心脏病急性加重期凝血状态与动脉血气的相关性及预后影响分析[J].广东医学,2016,37(2):221-223.
[16] Uchida T,Kanayama N,Kawai K,et al.Craniofacial tissue oxygen saturation is associated with blood pH using an examiner′s finger-mounted tissue oximetry in mice[J].Journal of Biomedical Optics,2016,21(4):40502-40503.
[17] 刘玉鹏,李溪远,丁圆,等.琥珀酰辅酶A连接酶缺陷导致继发性甲基丙二酸尿症四例的临床与实验室研究[J].中华儿科杂志,2016,54(5):365-369.
[18] 汪琳,张涛,白克镇.MTHFR基因C677T位点突变及高同型半胱氨酸血症和血管性痴呆的发生相关性[J].中风与神经疾病,2016,33(8):696-698.
[19] 刘莉,韩宇博,邹国良,等.射血分数保留的心力衰竭患者中医证型与游离脂肪酸和心型脂肪酸结合蛋白的相关性研究[J].辽宁中医杂志,2016,11(12):2555-2558.
[20] Ellen B,Brurberg KG,Eirik R,et al.ST waveform analysis versus cardiotocography alone for intrapartum fetal monitoring:A systematic review and meta-analysis of randomized trials[J].Acta Obstetricia Et Gynecologica Scandinavica,2016,95(1):16-18.
[21] 涂芊茜,赵宁,徐淼,等.急性心肌梗死患者血清心型脂肪酸结合蛋白水平与心功能参数的相关性[J].中国老年学杂志,2016,36(20):5037-5039.
[22] 周兴生,林文弢,何晓龙,等.男子足球运动员YO-YO测试与运动后血乳酸、心率变化相关性的分析[J].广州体育学院学报,2017,37(4):85-89.
[23] 徐晓燕,翟小琳,吕涛,等.不同血液病患者EB病毒和人巨细胞病毒核酸检测阳性率与年龄的相关性研究[J].中华医院感染学杂志,2017,27(7):1500-1503.
[24] 刘玉鹏,李溪远,丁圆,等.琥珀酰辅酶A连接酶缺陷导致继发性甲基丙二酸尿症四例的临床与实验室研究[J].中华儿科杂志,2016,54(5):365-369.
[25] 王娟,许兵兵,曾金祥,等.车前子醇提物与毛蕊花糖苷对实验性高尿酸血症小鼠的比较研究[J].中国新药与临床杂志,2016,11(9):653-659.