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