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目的探讨主观因素对新生儿1 min Apgar评分的影响。方法选择2011年10月至2013年9月在我院产科出生的新生儿为研究对象,婴儿出生后,由产科医生、儿科医生、麻醉科医生、助产人员、产科护士共5名医护人员在同一时间内进行1 min Apgar评分,将评分结果分为5组进行记录和分析。结果共对1300例新生儿进行1 min Apgar评分,5组医护人员评分结果完全相同的仅367例(28.2%);产科医生组评分最高,平均8.7分,儿科医生组评分最低,平均8.1分;在窒息发生率方面,产科医生组窒息发生率最低,为11.9%,助产人员组窒息发生率最高,为19.7%;单病例最大评分差距相差5分。结论主观因素对1 min Apgar评分有一定影响,需制定一套新的诊断标准以减少主观因素的影响,取消单一依靠Apgar评分诊断新生儿窒息是解决这一问题的最好方法。
Objective To explore the influence of subjective factors on Apgar score at 1 minute in neonates. Methods From October 2011 to September 2013, newborns born in obstetrics and gynecology department of our hospital were selected as research objects. After the baby was born, a total of five medical staff including obstetricians, pediatricians, anesthesiologists, midwifery staff and obstetric nurses At the same time 1 min Apgar score, the score is divided into 5 groups for recording and analysis. Results A total of 1,300 newborns were enrolled in this study. Apgar score was 1 min for 1,500 min, and only 367 patients (28.2%) were scored equally in 5 groups. The obstetrician group had the highest score of 8.7, and the pediatric group had the lowest score of 8.1. In the incidence of asphyxia, obstetricians group the lowest incidence of asphyxia, 11.9%, the highest incidence of asphyxia in the midwifery staff, was 19.7%; single case maximum score difference of 5 points. Conclusion The subjective factors have an impact on Apgar score at 1 min. A new diagnostic criteria should be developed to reduce the influence of subjective factors. Eliminating apgar score based on Apgar score is the best way to solve this problem.