【摘要】 目的探讨剖宫产与自然分娩对早产儿血气、电解质、肾功能、心肌酶、新生儿贫血、颅内出血和新生儿窒息的影响。方法选取2015年1月至2016年1月于钦州市妇幼保健院出生的早产儿80例,根据分娩方式将80例早产儿分为自然分娩组(36例)及剖宫产组(44例),对比两组早产儿产后1d内的血气、电解质、肾功能、心肌酶学、血常规、新生儿贫血、颅内出血和新生儿窒息情况。结果与剖宫产组相比,自然分娩组早产儿胎龄较小(t=2.523,P<0.05)。1min Apgar评分、5min Apgar评分、血红蛋白(Hb)、白细胞计数(WBC)、血小板计数(PLT)在自然分娩组与剖宫产组间比较差异无统计学意义(t值分别为0.705、0.421、1.666、1.292、0.097,均P>0.05)。酸碱度(pH)、碱剩余(BE)、碳酸氢根离子(HCO3-)在自然分娩组与剖宫产组间比较差异无统计学意义(t值分别为1.079、0.826、1.842,均P>0.05)。血Na、血Cl、血Cr、血尿素氮(BUN)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)在自然分娩组与剖宫产组间比较差异无统计学意义(t值分别为0.526、0.849、1.418、0.402、0.567、1.240,均P>0.05)。自然分娩组与剖宫产组新生儿窒息、贫血及颅内出血发生率对比,均无明显差异(χ~2值分别为1.935、2.184、2.018,均P>0.05)。结论剖宫产及自然分娩对早产儿血气、电解质、肾功能、心肌酶、新生儿窒息、新生儿贫血及颅内出血的影响无差别,因此临床上应严格掌控剖宫产的指征,以降低临床上剖宫产率。更多还原

【Abstract】 Objective To explore the influence of cesarean section and spontaneous delivery on blood gas,electrolyte,renal function and myocardial enzymes in premature infants and on neonatal anemia,intracranial hemorrhage and neonatal asphyxia. Methods Eighty premature infants born in Qinzhou Maternal and Child Health Care Hospital from January 2015 to January 2016 were selected and divided into spontaneous delivery group( 36 cases) and cesarean section group( 44 cases) according to delivery mode. Blood gas,electrolyte,renal function,myocardial enzymes,routine blood test,neonatal anemia,intracranial hemorrhage and neonatal asphyxia of premature infants at 1 day after delivery were compared between two groups. Results Compared to cesarean section group,premature infants in spontaneous delivery group had smaller gestational age( t = 2. 523,P < 0. 05). There were no statistically significant differences in 1min Apgar score,5min Apgar score,hemoglobin( Hb),white blood cell count( WBC),platelet count( PLT) between two groups( t value was 0. 705,0. 421,1. 666,1. 292 and 0. 097,respectively,all P > 0. 05). There were no significant differences in pH value( pH),base excess( BE),bicarbonate ion( HCO3-) between two groups( t value was 1. 079,0. 826 and 1. 842,respectively,all P > 0. 05). The differences were not significant in blood Na,blood Cl,blood Cr,blood urea nitrogen( BUN),creatine kinase( CK) and creatine kinase isoenzyme( CK-MB) between spontaneous delivery group and cesarean section group( t value was 0. 526,0. 849,1. 418,0. 402,0. 567 and 1. 240,respectively,all P > 0. 05). Comparison of incidences of neonatal asphyxia,anemia and intracranial hemorrhage between spontaneous delivery group and cesarean section group showed no significant difference( χ~2 value was 1. 935,2. 184 and 2. 018,respectively,all P > 0. 05). Conclusion There are no significant differences between influences of cesarean section and spontaneous delivery on blood gas,electrolyte,renal function,myocardial enzymes,neonatal asphyxia,anemia and intracranial hemorrhage in premature infants,so indications for cesarean section should be strictly controlled clinically to reduce rate of cesarean section.更多还原