阿普加分数

定义

Apgar is a quick test performed on a baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the health care provider how well the baby is doing outside the mother's womb. It also helps measure how well the baby responds if resuscitation is needed right after birth.

In rare cases, the test will be done 10 minutes after birth.

Virginia Apgar, MD (1909-1974) introduced the 阿普加分数 in 1952.

选择的名字

Newborn scoring; Delivery - Apgar

如何执行测试

The Apgar test is done by a doctor, midwife, or nurse. The health care provider examines the baby's:

• 呼吸的努力
• 心率
• 肌肉张力
• 反应
• 皮肤的颜色

Each category is scored with 0, 1, or 2, depending on the observed condition.

呼吸努力:

• If the infant is not breathing, the respiratory score is 0.
• If the respirations are slow or irregular, the infant scores 1 for respiratory effort.
• If the infant cries well, the respiratory score is 2.

心率 is evaluated by stethoscope. This is the most important assessment:

• If there is no heartbeat, the infant scores 0 for heart rate.
• If heart rate is less than 100 beats per minute, the infant scores 1 for heart rate.
• If heart rate is greater than 100 beats per minute, the infant scores 2 for heart rate.

肌肉:

• If muscles are loose and floppy, the infant scores 0 for muscle tone.
• If there is some muscle tone, the infant scores 1.
• If there is active motion, the infant scores 2 for muscle tone.

Grimace response or reflex irritability is a term describing response to stimulation, 如轻轻捏一下:

• If there is no reaction, the infant scores 0 for reflex irritability.
• If there is grimacing, the infant scores 1 for reflex irritability.
• If there is grimacing and a cough, 打喷嚏, 或是激烈的哭泣, the infant scores 2 for reflex irritability.

皮肤颜色:

• If the skin color is pale blue, the infant scores 0 for color.
• If the body is pink and the extremities are blue, the infant scores 1 for color.
• If the entire body is pink, the infant scores 2 for color.

为什么要进行测试

This test is done to determine whether a newborn needs help breathing or is having heart trouble.

正常的结果

The 阿普加分数 is based on a total score of 1 to 10. The higher the score, the better the baby is doing after birth.

A score of 7, 8, or 9 is normal and is a sign that the newborn is in good health. 得10分是很不寻常的, since almost all newborns lose 1 point for blue hands and feet, 出生后哪个是正常的.

异常结果意味着什么

Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs to adjust outside the mother's womb.

Most of the time a low 阿普加分数 is caused by:

• 难产
• 剖腹产
• 婴儿呼吸道有液体

A baby with a low 阿普加分数 may need:

• Oxygen and clearing out the airway to help with breathing
• Physical stimulation to get the heart beating at a healthy rate

Most of the time, a low score at 1 minute is near-normal by 5 minutes. 阿普加分数s are not usually measured after 5 minutes.

A lower 阿普加分数 does not mean a child will have serious or long-term health problems. The 阿普加分数 is not designed to predict the future health of the child.

If the 阿普加分数 is below 7 at the five-minute mark, some providers will check it a few minutes later to assess the effect of any action taken to correct any respiratory or cardiac concerns. If it is rechecked, that typically stops once the 阿普加分数 has reached 7.

参考文献

容易引起年代. 分娩时胎儿监护. In: 容易引起年代S, Robson MS, eds. Munro Kerr's Operative Obstetrics. 13日艾德. Philadelphia, PA: Elsevier; 2020:chap 9.

Goyal NK. 新生婴儿. 在:Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. 纳尔逊儿科学教材. 21艾德. Philadelphia, PA: Elsevier; 2020:chap 113.