抢救重度窒息新生儿的体会——附134例报告

Experience of Rescuing Severe Asphyxiant Neunate——Report of 134 Cases

我院新生儿科自1987年至1991年,抢救重度窒息儿134例。经抢救1分钟之内恢复自主呼吸的38例,5分钟恢复自主呼吸的70例,20分钟内有自主呼吸的15例。另8例经脐静脉给药,20分钟Apgar评述7分。3例患儿抢救30分钟以上仍未出现自主呼吸。抢救成活111例占82.8％,死亡23例占17.2％,足月适于胎龄儿无先天畸形者无1例死亡。对存活婴儿在出院时做了新生儿行为能力检查,对98例婴儿在生后1个月、3个月、6个月、1岁时进行了神经系统的复查,复查率88.3％,均呈良好反应。抢救成功的关键在于:产、儿科合作,抢救时执行A、B、C、D、E抢救方案,正确的氧疗,变换体位,氨茶硷、酚妥拉明、抗生素等药物的合理应用,短期禁食。有步骤地进行经口喂养等。

The neonatology department of our hospital had rescued 134 severe asphyxianl neonates from 1987 to 1991. There were 38 cases recovering autonomous respiration within one minute through rescuing, 70 cases within 5 minutes, 15 cases within 20 minutes, another 8 cases had 20 minute Apgar score≥7, 3 cases had no autonomous respiration after rescuing for more than 30 minutes. There wtre 111 cases being rescued survivors. The survival rate was 82.8%, 23 cases died (17.2%). No one died among full-term neonates who had no congenital deformity. We did nervous system examination at 98 infants in 1, 3, 6 months and one year after they were born. The reexamination rate was 88.3%, all the infants having good reaction. The keys to successful rescuing ares The cooperation of neonatal department with obstetrical department and application of A,B,C,D,E rescuing scheme, including right oxygen therapy, changing posture, rationally applying aminophylline, phentolamine, antibiotics etc., short term fasting, and carrying on feeding the infants from mouth step by step.