关键词: 窒息, 乳酸, 乳酸清除率, 振幅整合脑电图, 婴儿, 新生

Abstract:
Objective
To observe the relationship between arterial blood lactate, early lactate clearance rate, amplitude-integrated electronencephalogram(aEEG) and neonatal asphyxia, and to investigate the clinical values of arterial blood lactate, early lactate clearance rate and aEEG in neonatal asphyxia.
Methods
A total of 60 asphyxia neonates admitted to Affiliated Hospital of Yangzhou University from July 2015 to July 2017 were divided into mild asphyxia group(22 cases) and severe asphyxia group(38 cases); they were divided into resuscitation 5-minute correction group(n=26), resuscitation 10-minute correction group(n=24) and resuscitation more-than-10-minute correction group(n=10);they were divided into low-clearance group(n=15) and high-clearance group(n=45);they were divided into survival group(n=51) and death group(n=9). The levels of arterial blood lactate were detected at the time of admission and 6 hours after treatment, and aEEG was evaluated. The statistical analysis on the relationship between arterial blood lactate, early lactate clearance rate, aEEG and neonatal asphyxia was done respectively.
Results
The levels of arterial blood lactate in severe asphyxia group were higher than mild asphyxia group(P<0.05). The pH value, alkali residual value and Apgar score in severe asphyxia group were significantly lower than those in mild asphyxia group, while aEEG abnormal rate was significantly higher(P<0.05).Compared with resuscitation 10-minute correction group and resuscitation 5minute correction group, the arterial blood lactate levels of resuscitation more-than-10-minute correction group were significantly higher on admission and 6h after treatment(P<0.05). The pH value, alkali residual value and Apgar score in resuscitation more-than-10-minute correction group were lower than those in resuscitation 10-minute and 5-minute correction group(P<0.05).Compared with survival group, the arterial blood lactate levels of death group were significantly higher on admission and 6h after treatment(P<0.01). The pH value, alkali residual value and Apgar score in the death group were significantly lower than those in survival group(P<0.01). There was no difference in lactate level on admission between low-lactate-clearance-rate group and the high group(P<0.05).The mortality in low-lactate-clearance-rate group was higher than high-lactate-clearance-rate group(P<0.05). The levels of arterial blood lactate in abnormal aEEG group were higher than normal aEEG group(P<0.05).
Conclusion
Arterial serum lactate level, early lactate clearance rate and aEEG are reliable evidences for neonatal asphyxia diagnosis, severity judgment and prognosis evaluation.

Key words: Asphyxia, Lactate, Lactate clearance rate, Amplitude-integrated electronencephalogram, Infant, newborn