剖宫产术中新生儿呼吸道清理时机的讨论及临床应用

Discussion and Clinical Application of Respiratory Tract Cleaning Time of Newborn during Cesarean Section

目的:探究剖宫产术中新生儿呼吸道清理时机及对新生儿的影响。方法:选取2018年6月-2019年12月于本院行剖宫产术出生的150例新生儿,将其按呼吸道清理时机分为A、B、C组,每组50例。A组于胎头娩出后进行呼吸道清理,B组于完全娩出后进行呼吸道清理,C组于断脐后进行呼吸道清理。比较三组出生后1、5 min的新生儿窒息发生情况,出生后30、60 min的血气分析,以及羊水吸入综合征、24 h呕吐、新生儿呼吸道伤、拒乳发生率和负压吸引器使用时间。结果:A组出生后1、5 min的新生儿窒息发生情况和出生后30、60 min的血气分析结果均优于B组与C组(P<0.05)。A组羊水吸入综合征、24 h呕吐、新生儿呼吸道伤及拒乳发生率均低于B组与C组(P<0.05)。A组负压吸引器使用时间均短于B组与C组(P<0.05)。结论:胎头娩出后进行呼吸道清理在剖宫产新生儿中的应用效果相对更好,可显著改善新生儿氧供状态,应用价值相对更高。

Objective:To investigate the respiratory tract cleaning time of newborn during cesarean section and its influence for newborns.Method:From June 2018 to December 2019,150 newborns delivered by cesarean section in our hospital were selected.They were divided into group A,B and C according to the respiratory tract cleaning time,with 50 cases in each group.Group A underwent respiratory tract cleaning after delivery of fetal head,group B underwent respiratory tract cleaning after complete delivery,and group C underwent respiratory tract cleaning after umbilicus was broken.The incidence of neonatal asphyxia at 1 and 5 min after birth,the blood gas analysis at 30 and 60 min after birth,incidence of amniotic fluid inhalation syndrome,24 h vomiting,neonatal respiratory injury,breast rejection,and time of use of negative pressure aspirator.Result:The incidence of neonatal asphyxia in group A at 1 and 5 min after birth,and the results of blood gas analysis at 30 and 60 min after birth were all better than those in group B and C (P<0.05).The rate of amniotic fluid inhalation syndrome,vomiting within 24 h,neonatal respiratory injury and breast rejection in group A were lower than those in group B and C (P<0.05).The use time of negative pressure aspirators in group A was shorter than those in group B and C (P<0.05).Conclusion:The application effect of respiratory tract cleaning after fetal head delivery in newborn during cesarean section is relatively better,which can significantly improve the state of newborn oxygen supply,and the application value is relatively higher.