新生儿视网膜出血与脐动脉血气分析变化相关性研究OACSTPCD

AIM:To explore the correlation between neonatal retinal hemorrhage(RH)and changes in umbilical artery blood gas analysis. METHODS:A total of 312 full-term neonates born in our obstetrics department from January 2019 to December 2021 were selected as the study subjects.According to the RetCam Ⅲ fundus examination results,245 neonates who did not experience RH were included in the control group,while 67 cases with RH were found to be included in the RH group.In addition,neonates were grouped into I degree group(n=20),Ⅱ degree group(n=29),and Ⅲdegree group(n=18)based on the degree of RH.General clinical data and umbilical artery blood gas analysis indicators between the RH group and the control group were compared;the levels of umbilical artery blood gas analysis indicators in neonates with different degrees of RH,the relationship between pH and RH degree,and the influencing factors of neonatal RH were analyzed. RESULTS:There was no obvious difference in maternal age,average gestational week,fetal gender,parity,gestational diabetes,fetal birth weight,and amniotic fluid between the RH group and the control group(all P＞0.05),while there were obvious differences in delivery methods,gestational hypertension,forceps assisted delivery,neonatal asphyxia,and umbilical cord around the neck(all P＜0.05).The pH value,arterial blood sample partial pressure(PaO2)and base excess(BE)values of the RH group were obviously lower than those of the control group(all P＜0.01),while the arterial carbon dioxide partial pressure(PaCO2)was obviously higher than that of the control group(P＜0.01).There were obvious differences in umbilical artery blood gas analysis indicators among children with different degrees of RH(P＜0.05),and with the increase of the degree of RH,pH value,PaO2 and BE gradually decreased(P＜0.05),and PaCO2 gradually increased(P＜0.05).There was a negative correlation between the degree of RH and the pH of umbilical artery blood gas analysis(rs=-0.593,P＜0.05).The results of multivariate Logistic regression analysis showed that delivery method,gestational hypertension,forceps assisted delivery,neonatal asphyxia,umbilical cord entanglement,pH,PaO2,PaCO2,and BE were all influencing factors for the occurrence of neonatal RH. CONCLUSION:There is a close correlation between neonatal RH and changes in umbilical artery blood gas analysis,and umbilical artery blood gas analysis can be used for the diagnosis of neonatal RH,which can be used to guide clinical treatment.