新生儿窒息复苏中应用不同氧浓度的临床效果
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摘要
目的探讨新生儿窒息复苏过程中应用不同氧浓度的临床效果。方法将2014年1月至2016年12月在我院娩出的99例窒息新生儿作为研究对象,并将其按照复苏方案的不同分成观察1组33例(高浓度氧复苏)、观察2组33例(低浓度氧复苏)及对照组33例(空气复苏),分别对3组新生儿的临床复苏效果、Apgar评分、血气指标水平及不良事件情况进行对比。结果观察2组新生儿的临床复苏有效率明显高于其他组; 3组新生儿在出生1 min Apgar评分差异不明显,观察2组新生儿在出生5 min、10 min Apgar评分明显高于观察1组与对照组; 3组新生儿在pH值与PCO_2水平上差异不明显,观察1组在PO_2水平上明显高于观察2组与对照组;观察2组新生儿在脑损伤及氧中毒发生率上明显低于其他组。结论新生儿窒息复苏过程中应用低浓度氧复苏的临床效果最佳,可明显改善新生儿的不良症状,同时降低复苏过程中脑损伤及氧中毒的发生风险,值得在临床推广应用。
Objective To investigate the clinical effects of different oxygen concentrations on neonatal asphyxia resuscitation. Methods There are 99 neonatal asphyxiacases collected from our hospital from January 2014 to December 2016. They were randomly divided into 3 groups based on the resuscitation scheme: observation group 1 including 33 cases with high oxygen concentration resuscitationn,observation Group 2 including 33 cases with low oxygen concentration resuscitation and one control group including 33 cases with normal oxygen concentration resuscitation in air. Clinical resuscitation effects were compared including Apgar score,blood gas tests and adverse events of these three groups. Results The efficiency of clinical neonatal resuscitation in observation group 2 was significantly higher than those of the other two groups. There was no significant difference in the Apgar scores of three groups within the 1 minute of the birth. The Apgar scores in observation group 2 at 5 min and 10 min were significantly higher than those of the other two groups. There were no significant differences in pH and PCO_2 levels in three groups. The PO_2 level in observation group 1 was significantly higher than those of the other two groups. Observation group 2 had a lower occurrence rate in brain injury and oxygen toxicity than those of the other groups. Conclusion The clinical effect of resuscitation with low oxygen concentration is best during the resuscitation of neonatal asphyxia,which can obviously improve the neonatal adverse symptoms and reduce the risk of brain injury and oxygen toxicity during resuscitation. It is worthy of clinical application.
Objective To investigate the clinical effects of different oxygen concentrations on neonatal asphyxia resuscitation. Methods There are 99 neonatal asphyxiacases collected from our hospital from January 2014 to December 2016. They were randomly divided into 3 groups based on the resuscitation scheme: observation group 1 including 33 cases with high oxygen concentration resuscitationn,observation Group 2 including 33 cases with low oxygen concentration resuscitation and one control group including 33 cases with normal oxygen concentration resuscitation in air. Clinical resuscitation effects were compared including Apgar score,blood gas tests and adverse events of these three groups. Results The efficiency of clinical neonatal resuscitation in observation group 2 was significantly higher than those of the other two groups. There was no significant difference in the Apgar scores of three groups within the 1 minute of the birth. The Apgar scores in observation group 2 at 5 min and 10 min were significantly higher than those of the other two groups. There were no significant differences in pH and PCO_2 levels in three groups. The PO_2 level in observation group 1 was significantly higher than those of the other two groups. Observation group 2 had a lower occurrence rate in brain injury and oxygen toxicity than those of the other groups. Conclusion The clinical effect of resuscitation with low oxygen concentration is best during the resuscitation of neonatal asphyxia,which can obviously improve the neonatal adverse symptoms and reduce the risk of brain injury and oxygen toxicity during resuscitation. It is worthy of clinical application.
引文
[1]古玉芳,曾贵祥,蒙莉,等.不同氧浓度对新生儿窒息复苏脑损伤的影响[J].中国医药导报,2017,14(27):116-119.
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[6]卢慧琴,赵秀敏,李香娟,等.新生儿窒息空气复苏技术在基层医院的应用及评估[J].中国妇幼保健,2014,29(15):2443-2445.
[7]李鸿斌,冯海娟,陈继华,等.复苏技术降低中国新生儿窒息发生率和死亡率的系统评价[J].中国循证医学杂志,2016,16(12):1454-1464.
[8]李晋辉,伍金林.早产儿产房复苏用氧的相关问题[J].中华妇幼临床医学杂志(电子版),2014,10(6):807-810.
[9]刘涛.新生儿重度窒息的抢救与护理[J].中国保健营养,2017,27(8):170-171.
[10]卢慧琴,赵秀敏,李香娟,等.空气与纯氧复苏患儿12个月体格发育及智力发育的随访研究[J].中国妇幼保健,2014,29(28):4570-4571.
[11]谢冠浓,胡碧环,倪明军,等.窒息极早产儿采用不同氧浓度的复苏效果评价[J].临床医学工程,2016,23(6):761-762.
[12]孟宪涛,崔培聪,何立乾.不同浓度的氧复苏治疗新生儿窒息的临床效果及对新生儿脑损伤的影响[J].中国妇幼保健,2017,32(16):3791-3794.
[13]梁明姬,马国哲,韩芳,等.足月新生儿窒息时复苏采用氧浓度与脑损伤的相关性[J].热带医学杂志,2016,16(8):1033-1036.
[14]吴小玲.不同的氧浓度在新生儿窒息抢救中的应用[J].深圳中西医结合杂志,2015,25(4):21-22.
[15]胡碧环.使用40%氧及纯氧复苏早产儿的临床对比分析[J].现代医用影像学,2015,24(3):515-517.
[2]张小蕾.新生儿窒息的原因及窒息后并发多脏器损害的临床研究[J].中国医药指南,2017,15(19):75-76.
[3]中国新生儿复苏项目专家组.新生儿复苏指南(2016年北京修订)[J].中国围产医学杂志,2017,32(14):1058-1062.
[4]中国新生儿复苏项目专家组.中国新生儿复苏教程更新及中国实施意见[J].中华围产医学杂志,2018,21(2):73-80.
[5]姜雅洁.新生儿窒息的抢救及有效护理方法分析[J].中国保健营养,2017,27(16):294-295.
[6]卢慧琴,赵秀敏,李香娟,等.新生儿窒息空气复苏技术在基层医院的应用及评估[J].中国妇幼保健,2014,29(15):2443-2445.
[7]李鸿斌,冯海娟,陈继华,等.复苏技术降低中国新生儿窒息发生率和死亡率的系统评价[J].中国循证医学杂志,2016,16(12):1454-1464.
[8]李晋辉,伍金林.早产儿产房复苏用氧的相关问题[J].中华妇幼临床医学杂志(电子版),2014,10(6):807-810.
[9]刘涛.新生儿重度窒息的抢救与护理[J].中国保健营养,2017,27(8):170-171.
[10]卢慧琴,赵秀敏,李香娟,等.空气与纯氧复苏患儿12个月体格发育及智力发育的随访研究[J].中国妇幼保健,2014,29(28):4570-4571.
[11]谢冠浓,胡碧环,倪明军,等.窒息极早产儿采用不同氧浓度的复苏效果评价[J].临床医学工程,2016,23(6):761-762.
[12]孟宪涛,崔培聪,何立乾.不同浓度的氧复苏治疗新生儿窒息的临床效果及对新生儿脑损伤的影响[J].中国妇幼保健,2017,32(16):3791-3794.
[13]梁明姬,马国哲,韩芳,等.足月新生儿窒息时复苏采用氧浓度与脑损伤的相关性[J].热带医学杂志,2016,16(8):1033-1036.
[14]吴小玲.不同的氧浓度在新生儿窒息抢救中的应用[J].深圳中西医结合杂志,2015,25(4):21-22.
[15]胡碧环.使用40%氧及纯氧复苏早产儿的临床对比分析[J].现代医用影像学,2015,24(3):515-517.