CN108269615A - A kind of bleeding of the umbilicus pH value and the relationship evaluation method of infant brain damage - Google Patents
A kind of bleeding of the umbilicus pH value and the relationship evaluation method of infant brain damage Download PDFInfo
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- CN108269615A CN108269615A CN201810210087.3A CN201810210087A CN108269615A CN 108269615 A CN108269615 A CN 108269615A CN 201810210087 A CN201810210087 A CN 201810210087A CN 108269615 A CN108269615 A CN 108269615A
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Abstract
The invention belongs to medical system fields, disclose a kind of bleeding of the umbilicus pH value and the relationship evaluation method of infant brain damage, and evaluation method includes：Cord Blood of Neonates pH value and the Denver developmental screening DDST correlations to score are evaluated；Cord Blood of Neonates pH value and the bud jasmine infant development scale BSID correlations to score are evaluated；Head B-sonography damage to two groups is evaluated.The present invention has predictive value using umbilical Blood Gas Analysis in the generation and prognosis of hypoxic-ischemic brain damage, can find hypoxic-ischemic brain damage early and take protection and intervening measure in early days, can effectively reduce the incidence of the sequelae of cerebral injury.
Description
Technical field
The invention belongs to medical system field more particularly to a kind of bleeding of the umbilicus pH value and the relationship evaluation sides of infant brain damage
Method.
Background technology
Hypoxic ischemic encephalopathy of newborn (hypoxie-ischemic encephalopathy, HIE) referred in perinatal period
Anoxia asphyxia and the hypoxic ischemic of brain is caused to damage, including characteristic europathology and pathophysiological process, and in clinic
Upper a series of encephalopathy performance occur, part children can leave different degrees of nervous system sequelae.Clinic occurs a series of
Encephalopathy shows, and gently then shows as brain injury sequela, heavy then threat to life.Cause after asphyxia neonatorum HIE be neonatal death,
The one of the major reasons to disable.But partial brain damage infant is found by clinical observation, there is no apparent Following Hypoxia in Uterus diseases
History and Apgar score low situation.Since neonates with HIBD lacks clinical manifestation and the specificity of specificity
Diagnosis index, there is no a kind of objective and accurate method at present to judge neonatal Hypoxia Brain Injury situation, it is how early
Phase accurately judges that anoxia neonatorum situation is always to perplex the problem of obstetrics and neonate department doctor.
In conclusion problem of the existing technology is：Since neonates with HIBD lacks specificity
Clinical manifestation and the diagnosis index of specificity, there is no a kind of objective and accurate method to judge neonatal Hypoxia Brain Injury at present
How in early days, accurately situation judges that anoxia neonatorum situation is always to perplex the problem of obstetrics and neonate department doctor.
Invention content
In view of the problems of the existing technology, the relationship damaged the present invention provides a kind of bleeding of the umbilicus pH value with infant brain is commented
Valency method.
The invention is realized in this way a kind of bleeding of the umbilicus pH value and the relationship evaluation method of infant brain damage, the bleeding of the umbilicus
The relationship evaluation method that pH value is damaged with infant brain includes：
Cord Blood of Neonates pH value and the Denver developmental screening DDST correlations to score are evaluated；
Cord Blood of Neonates pH value and the bud jasmine infant development scale BSID correlations to score are evaluated；
Head B-sonography damage to two groups is evaluated.
Further, the relationship evaluation method that the bleeding of the umbilicus pH value is damaged with infant brain specifically includes：
Step 1, selection analysis object；
Step 2, arteria umbilicalis blood gas analysis when being born to analysis object；
Step 3 collects clinical data, including childbirth options, birth weight, gestational age, birth Apgar scorings, amniotic fluid feelings
Condition；
Step 4 is divided into two groups, 7.1 groups of pH value ＜ 7.1, pH value ＞ according to bleeding of the umbilicus pH value；
Step 5 carries out DDST scorings and BSID scorings at 3 monthly age respectively；
Step 6,4-5 days and progress head B-sonography imaging of selecting a good opportunity March after life；
Step 7, statistical analysis carry out data statistics with SPSS19.0 statistical softwares.
Further, in step 1,37-40 weeks utility evaluation of childbirth is included in analysis,.
Further, in step 2, before newborn gives birth to and does not set up autonomous respiration, divided with blood gas analyzer
Analysis.
Further, in step 7, comparison each group data carries out statistical analysis, enumeration data chi-square criterion, metering money
Material is examined with t, and P ＜ 0.05 are statistically significant.
Another object of the present invention is to provide a kind of bleeding of the umbilicus pH value and the relationship evaluation system of infant brain damage.
Advantages of the present invention and good effect are：The present invention analyzes bleeding of the umbilicus pH value and the relationship of infant brain damage, hair
Existing umbilical Blood Gas Analysis has the Index for diagnosis of Neonatal Brain Damage important value, and the scoring of umbilical Blood Gas Analysis bonding behavior can be more
The comprehensively situation of the development of evaluation newborn baby and cerebral injury, assesses prognosis, deviates normal child to intellectual development and accomplishes morning
It was found that, early diagnosis, early treatment intervene early, the opportunity for making full use of early stage plasticity of neural system strong improves environment and progress
Training promotes the compensatory rehabilitation of baby, the incidence of disability is made to be reduced to a minimum, umbilical Blood Gas Analysis is in hypoxia-ischemia brain
The generation and prognosis of damage have predictive value, find hypoxic-ischemic brain damage early and protection and intervention is taken to arrange in early days
It applies, can effectively reduce the incidence of the sequelae of cerebral injury.
The two groups of DDST scorings and BSID scorings of the present invention is compared, and difference is statistically significant (P ＜ 0.05), pH value ＜
7.1 groups of DDST scorings and BSID scorings are relatively low.7.1 groups of pH value ＜ is in HIE clinical gradings and head B-sonography severity, NBNA
Less than 7.2 groups of pH value ＞ in terms of scoring, there is significant difference (P ＜ 0.05), it was demonstrated that：Umbilical cord blood PH value is less than 7.1 infants
Cerebral injury is big, poor prognosis；Umbilical Blood Gas Analysis has necessity and importance as routine inspection in clinical practice.
Description of the drawings
Fig. 1 is the flow chart of bleeding of the umbilicus pH value provided in an embodiment of the present invention and the relationship evaluation method of infant brain damage.
Specific embodiment
In order to make the purpose , technical scheme and advantage of the present invention be clearer, with reference to embodiments, to the present invention
It is further elaborated.It should be appreciated that the specific embodiments described herein are merely illustrative of the present invention, it is not used to
Limit the present invention.
Below in conjunction with the accompanying drawings and specific embodiment is further described the application principle of the present invention.
The relationship evaluation method that bleeding of the umbilicus pH value provided in an embodiment of the present invention is damaged with infant brain includes：
Cord Blood of Neonates pH value and the Denver developmental screening DDST correlations to score are evaluated；
Cord Blood of Neonates pH value and the bud jasmine infant development scale BSID correlations to score are evaluated；
Head B-sonography damage to two groups is evaluated.
As shown in Figure 1, the relationship evaluation method that bleeding of the umbilicus pH value provided in an embodiment of the present invention is damaged with infant brain includes
Following steps：
S101, selection analysis object；
S102, arteria umbilicalis blood gas analysis when being routinely born to analysis object；
S103 collects other clinical datas, including childbirth options, birth weight, gestational age, birth Apgar scorings, amniotic fluid feelings
Condition etc.；
S104 is divided into two groups, i.e. pH value ＜ 7.1 (38), 7.1 groups of pH value ＞ (89) according to bleeding of the umbilicus pH value；
S105 carries out DDST scorings and BSID scorings at 3 monthly age respectively；
S106,4-5 days and progress head B-sonography imaging of selecting a good opportunity March after life, all cases are using Siemens 3.0T superconduction types
NMR imaging instrument, routine MRI are axle position T1WI, T2WI and FLAIR as sagittal plain, T2WI and Coronal FLAIR pictures；
S107, statistical analysis carry out data statistics with SPSS19.0 statistical softwares.
It is in S101, in January, 2013 is big in December, 2015 Guangxi Medical University's third affiliated hospital and Guangxi medical courses in general
37-40 weeks utility evaluation for learning the 5th affiliated hospital's vaginal delivery is included in analysis, and cerebral injury may be caused by excluding other
Infant (1. fetus oneself factors, such as congenital disorders, encephalodysplasia, intrauterine growth retardation；2. mother's influence factor, such as
Diabetes (including gestational diabetes), hyperthyroidism are taken drugs, autoinfection disease etc.；3. placenta and umbilical factors, as placenta is different
Often, cord around neck leads to following intrauterine distress etc.；4. the influence of neonatal period other diseases：As asphyxia neonatorum, anoxia neonatorum lack
Courageous and upright encephalopathy, neonatal period severe hypoglycemia or severe infections, hyperbilirubinemia etc.).
In S102, before newborn gives birth to and does not set up autonomous respiration, immediately with two haemostatic clamp icarcerations, one section of navel
Band blood vessel, the arterial blood of this section of umbilical cord is extracted with heparinized syringe, and sample sealing is analyzed immediately with blood gas analyzer.
In S105, served as by fixed neonate department attending physician more than academic title doctor, and by profession DDST and BSID
The study of scoring training class；The DDST-R amounts that DDST tests are standardized again using the normal child that children in Beijing health centre formulates
Table is tested its people-society, fine-motion-with adaptive behavior, language and 4 Ge Neng areas of big movement for 104, as a result totally
It is normal, abnormal+suspicious；1st screening results are case that is abnormal, suspicious abnormal or can not evaluating, and 2 have been done in 1 week
Secondary above check, is made a definite diagnosis in conjunction with clinical data；BSID is with mental development index (mental development
Index, MDI) and mental development index (psychomotor development index, PDI) expression, MDI, PDI ＜
70 be abnormal；The DDST scorings of two groups of comparative analysis and BSID score whether there is significant difference respectively.
In S106, when checking MRI, newly born infant blood oxygen saturation and heart rate are monitored using 4500 type MRI Oximeter,
Newborn is in natural sleep state after sucking, it is impossible to which sleep person, anus fills after being diluted using 10% chloraldurate 0.5ml/kg
Enter.It is bilateral frontal lobe, temporal lobe, occipital lobe, top (hemisphere) that MRI, which is mainly (1) manifestations of cerebral edema to the description of HIE and indexing standard,
Extensive brain edema in white matter, cinereum matter boundary obscure, extensive low signal in the upper white matters of T1WI, the extensive high RSTs of T2WI；
(2) intracranial hemorrhage cortex and subcortical white matter bleeding can be divided into according to bleeding part, subarachnoid hemorrhage, deep white matter of brain go out
4 kinds of hypotypes of blood and ventricles of the brain germinal layer and intraventricular hemorrhage etc.；(3) cortex and ventricles of the brain aside matter are damaged frontal lobe, pillow on T1WI
Low signal under the focal cortex of leaf and in ventricles of the brain aside matter is compared with the higher signal of white matter on T2WI；(4) basal ganglia region and brain stem
Damage basal ganglia region, thalamus and brain stem back side are shown in uniform or uneven, symmetrical and asymmetric high RST on T1WI, and T2WI is low
Signal.
In S107, comparison each group data carries out statistical analysis, enumeration data chi-square criterion, and measurement data is examined with t,
P ＜ 0.05 are statistically significant.
Result is as follows by analysis：
1. two groups of infant general information of table compare
2 two groups of DDST screening results of table compare
3 two groups of BSID appraisal results of table
Note：A is compared with 7.1 groups of pH ＜, P values ＜ 0.01；B is compared with 7.1 groups of pH ＜, P values ＜ 0.01
4 two groups of head B-sonography situations of table
Note：* compared with being more than 7.1 groups with pH, P values ＜ 0.01；
It discusses：
One of the main reason for HIE is newborn's deformity and is dead.There are about 1,000,000 newborns every year to die of the disease in the whole world,
Ten thousand brain paralysis of 40-50 and disabled infant are caused by HIE.Deformity performance includes：Blindness, deafness, self-closing disease, epilepsy, intellectual development
Slow and cognitive disorder, fine movement and behavior disorder.White elephant is all caused to children and family, society.Enclose production
Phase neonatal hypoxia ischemia is one of most important reason of Neonatal Brain Damage, is for many years scored both at home and abroad usually using Apgar
Method judges that newborn has no asphyxia and its degree rapidly, simple and practicable, but subjectivity is strong, easily affected by many factors, and
And it cannot reflect anoxia neonatorum and the degree of acid poisoning completely.How by effective earlier evaluations, pai n nursing reduces new
The generation of raw youngster's brain injury sequela becomes the analysis hot spot in newborn field.
NBNA, BSID, PDMS scoring are at present compared with the means of thoroughly evaluating neonatal behavior neural capacity, are in recent years domestic
The easier reliable method of clinical analysis of newborn is widely used in, it is preferable to the assessment operability of Newborn's cord,
Neonatal behavior ability can be correctly assessed by scoring.Point out that umbilical Blood Gas Analysis combination Apgar is commented in 2014 analysis
It is point more accurate than simple Apgar scorings, more objectively reflect anoxia neonatorum and acid poisoning degree.This analysis is further discovered that
Infant BSID, PDMS scoring of 7.1 groups of pH ＜ is low, and prognosis is poor, 7.1 groups of pH ＞, and each item rating shows bleeding of the umbilicus blood close to normally
Qi leel analysis is closely related with the prognosis of Neonatal Brain Damage, and the possibility that sequelae occurs in the low infant of pH value is high.Blood gas analysis
Directly reflect fetus or neonatal acid-base balance state, more objective foundation is provided for diagnosing fetal and asphyxia neonatorum.
This analysis finds that umbilical Blood Gas Analysis has important value to the Index for diagnosis of Neonatal Brain Damage.Umbilical Blood Gas Analysis bonding behavior
Scoring can more fully evaluate the situation of newborn baby development and cerebral injury, assess prognosis, deviate intellectual development normal children
Youngster accomplishes that early discovery, early diagnosis, early treatment are intervened early, and the opportunity for making full use of early stage plasticity of neural system strong improves ring
It border and is trained, promotes the compensatory rehabilitation of baby, the incidence of disability is made to be reduced to a minimum.
The head B-sonography of HIE be mainly shown as brain edema, intracranial hemorrhage, cortex ventricles of the brain aside matter is damaged and basal ganglia region
Brain-stem injury originally analysis shows that 7.1 groups of craniocerebral injuries of pH ＜ are more serious, further prompts the necessity of blood gas analysis.
Summary, umbilical Blood Gas Analysis have predictive value in the generation and prognosis of hypoxic-ischemic brain damage.Early
It was found that hypoxic-ischemic brain damage and taking protection and intervening measure in early days, the generation of the sequelae of cerebral injury can be effectively reduced
Rate
The foregoing is merely illustrative of the preferred embodiments of the present invention, is not intended to limit the invention, all essences in the present invention
All any modification, equivalent and improvement made within refreshing and principle etc., should all be included in the protection scope of the present invention.
Claims (5)
1. a kind of bleeding of the umbilicus pH value and the relationship evaluation method of infant brain damage, which is characterized in that the bleeding of the umbilicus pH value and baby children
The relationship evaluation method of youngster's cerebral injury includes：
Cord Blood of Neonates pH value and the Denver developmental screening DDST correlations to score are evaluated；
Cord Blood of Neonates pH value and the bud jasmine infant development scale BSID correlations to score are evaluated；
Head B-sonography damage to two groups is evaluated.
2. bleeding of the umbilicus pH value as described in claim 1 and the relationship evaluation method of infant brain damage, which is characterized in that the navel
The relationship evaluation method that blood pH value is damaged with infant brain specifically includes：
Step 1, selection analysis object；
Step 2, arteria umbilicalis blood gas analysis when being born to analysis object；
Step 3 collects clinical data, including childbirth options, birth weight, gestational age, birth Apgar scorings, amniotic fluid situation；
Step 4 is divided into two groups, 7.1 groups of pH value ＜ 7.1, pH value ＞ according to bleeding of the umbilicus pH value；
Step 5 carries out DDST scorings and BSID scorings at 3 monthly age respectively；
Step 6,4-5 days and progress head B-sonography imaging of selecting a good opportunity March after life；
Step 7, statistical analysis carry out data statistics with SPSS19.0 statistical softwares.
3. bleeding of the umbilicus pH value as claimed in claim 2 and the relationship evaluation method of infant brain damage, which is characterized in that in step
In one, 37-40 weeks utility evaluation of childbirth is included in analysis.
4. bleeding of the umbilicus pH value as claimed in claim 2 and the relationship evaluation method of infant brain damage, which is characterized in that in step
In two, before newborn gives birth to and does not set up autonomous respiration, analyzed with blood gas analyzer.
5. bleeding of the umbilicus pH value as claimed in claim 2 and the relationship evaluation method of infant brain damage, which is characterized in that in step
In seven, comparison each group data carries out statistical analysis, enumeration data chi-square criterion, and measurement data is examined with t, and P ＜ 0.05 have system
Meter learns meaning.
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| WO2023155535A1 (en) * | 2022-02-15 | 2023-08-24 | 苏州大学 | Prediction markers for brain injury in preterm infants, prediction model, and system |
| CN117079822A (en) * | 2023-10-17 | 2023-11-17 | 北京大学第三医院（北京大学第三临床医学院） | System and method for predicting fetal brain injury by four factors in early and middle gestation period |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN102036671A (en) * | 2008-03-28 | 2011-04-27 | 永生细胞生技股份有限公司 | Treatment of brain damage using umbilical cord blood cells |
Non-Patent Citations (2)
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| 何芳: "小儿心理社会发育的评价方法", 《发育医学电子杂志》 * |
| 聂春梅: "脐血血气指标、脑血流动力学检测及Apgar 评分评估缺血缺氧性脑病高危患儿预后的意义", 《中国妇幼保健》 * |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2023155535A1 (en) * | 2022-02-15 | 2023-08-24 | 苏州大学 | Prediction markers for brain injury in preterm infants, prediction model, and system |
| CN117079822A (en) * | 2023-10-17 | 2023-11-17 | 北京大学第三医院（北京大学第三临床医学院） | System and method for predicting fetal brain injury by four factors in early and middle gestation period |
| CN117079822B (en) * | 2023-10-17 | 2024-01-02 | 北京大学第三医院（北京大学第三临床医学院） | System for predicting fetal brain injury by four factors in early and middle gestation period |
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