阿氏评分0～1分极重窒息儿45例产房复苏的成败

RESUSCITATION OF 45 CASES OF SEVERE ASPHYXIATED NEWBORN WITH APGAR SCORE 0-1 IN OELIVERY ROOM

6年内45例阿氏评分0～1分极重窒息儿经ABCDE复苏方案抢救成功29例(64.4％),且病死率呈递减趋势(42.9％～25.5％)。故迅速有效的复苏能挽救多数,其中ABC前三步尤为重要、碳酸氢钠要慎用,因血气表明此类患儿即使作了气管插管也难确保良好通气。做到评分快、插管快、动作群完成快是对复苏者必备的技术要求。

During a 6-year period 45 cases of severe asphyxiated newborn with Apgar score only 0-1 were resuscitated by use of A (airway) , B (breath- ing), C (circulation), D (drug), E (evaluation) approach in delivery room, of which 29 cases (64.4%) surved successfully with a gradually going-down trend of fatality rates (42.9%-25.0%). It was showed that such a approach and its rapid and effective procedures would rescue most of these moribound infants, and its former 3 steps of ABC were most important and indispen- sable. Sodium bicarbonate should be used (if necessary) with overcausion, because their blood gas analysis revealed a higher PCO_2 even with endo- tracheal intubation. Managing to quickly score, quickly intubate, and qui- ckly act was an essential technical request for the resuscitating person.