7.2且BE>-8)。根据围产期缺氧病史、临床表现、实验室检查和影像学检查等诊断新生儿窒息多器官损害。结果共纳入新生儿窒息患儿111例,其中轻度窒息79例,重度窒息32例。(1)脐动脉血气p H和BE与1 min Apgar评分成正相关(p H:r=0.223,P=0.016;BE:r=0.293,P=0.002)。(2)多因素分析显示胎心监护异常是影响血气p H和BE的重要因素(β=0.080,95%CI 0.010~0.160,P=0.025)。(3)重度窒息组多器官损害发生率显著高于轻度窒息组(75.0%比29.1%,χ~2=17.810,P<0.001)。轻度窒息合并严重酸中毒、非严重酸中毒和无酸中毒组多器官损害发生率分别为52.9%、26.3%、16.7%,酸中毒组多器官损害发生率高于无酸中毒组,差异有统计学意义(χ~2=6.623,P=0.036);重度窒息合并严重酸中毒、非严重酸中毒和无酸中毒组多器官损害发生率分别为80.0%、76.9%、50.0%,均较高,三组比较差异无统计学意义(χ~2=1.559,P=0.459)。(4)患儿1 min Apgar评分0~3分预测窒息多器官损害的敏感度和特异度分别为52.2%和87.1%;脐动脉血p H≤7和BE≤-16的敏感度分别为42.6%和38.3%,特异度分别为87.6和92.2%。(5)Apgar评分、脐动脉血p H和BE多项指标综合用于窒息后多器官损害敏感度和特异度评价,1 min Apgar评分0~3分、5 min Apgar评分≤5分、脐动脉血p H≤7和BE≤-16 mmol/L具有较高的特异度(71.9%)和敏感度(74.5%)。结论脐动脉血p H和BE可准确评价新生儿窒息和窒息多器官损害,结合生后Apgar评分有助于提高诊断新生儿窒息的准确率及预测窒息多器官损害和预后。 Objective To investigate the correlation between neonatal umbilical artery blood gas analysis and perinatal high risk factors, Apgar score and multiple organ damage after asphyxia. Methods The neonatal and neonatal intensive care units in the Collaborating Hospital from November 2012 to December 2014 were selected for gestational age> 34 weeks. After neonatal asphyxia neonates with umbilical arterial blood p H and BE were diagnosed, according to Apgar score Neonatal asphyxia, mild asphyxia group and severe asphyxia group were divided into severe metabolic acidosis group (p H≤7 and / or BE≤-16 mmol / L) according to cord blood gas analysis, non-severe metabolic acidosis group (7

7.2 and BE> -8). According to the history of perinatal hypoxia, clinical manifestations, laboratory tests and imaging studies diagnosed neonatal asphyxia multiple organ damage. Results A total of 111 cases of neonatal asphyxia were enrolled, of which 79 cases were mild asphyxia and 32 cases were severe asphyxia. (1) There was a positive correlation between p H and BE in umbilical arterial blood and Apgar score at 1 min (p = 0.223, P = 0.016; BE: r = 0.293, P = 0.002). (2) Multivariate analysis showed that abnormal fetal heart rate monitoring was an important factor influencing blood gas p H and BE (β = 0.080, 95% CI 0.010 ~ 0.160, P = 0.025). (3) The incidence of multiple organ damage in severe asphyxia group was significantly higher than that in mild asphyxia group (75.0% vs. 29.1%, χ ~ 2 = 17.810, P <0.001). The incidence of multiple organ damage in mild asphyxia with severe acidosis, non-severe acidosis and non-acidosis were 52.9%, 26.3%, 16.7% respectively. The incidence of multiple organ damage in acidosis group was higher than that in no acidosis group Statistical significance (χ ~ 2 = 6.623, P = 0.036). The incidence of multiple organ damage in severe asphyxia with severe acidosis, severe acidosis and non-acidosis were 80.0%, 76.9% and 50.0% There was no significant difference between the three groups (χ ~ 2 = 1.559, P = 0.459). (4) The sensitivity and specificity of Apgar score of 1 to 3 minutes were 52.2% and 87.1%, respectively. The sensitivities of umbilical arterial blood with p H≤7 and BE≤-16 were 42.6 % And 38.3%, the specificity was 87.6 and 92.2% respectively. (5) Apgar score, umbilical arterial blood p H and BE multiple indicators comprehensive evaluation of sensitivity and specificity of multiple organ damage after asphyxia, 1 min Apgar score 0 to 3 minutes, 5 min Apgar score ≤ 5 points, umbilical artery Blood p H ≤ 7 and BE ≤-16 mmol / L had higher specificity (71.9%) and sensitivity (74.5%). Conclusion The umbilical arterial blood samples p H and BE can be used to evaluate neonatal asphyxia and apnea multiple organ damage accurately. Apgar score can help to improve the accuracy of neonatal asphyxia and predict asphyxial multiple organ damage and prognosis.