新生儿窒息复苏新指南应用效果之评价

Commentary on the effects of new neonatal rResuscitation Guidelines

目的提高新生儿窒息复苏成功率,降低新生儿窒息死于分娩现场的发生率,减少致残率。方法将符合病例纳入标准的患儿分成研究组和对照组,对照组为2000～2005年未实行产儿科合作前在我院分娩的活产新生儿,研究组为2010年6月至2011年6月实行产儿科合作后在我院分娩活产新生儿,新生儿娩出后由课题组成员参与及指导复苏,并进行Apgar评分,对窒息儿进行记录评分、抢救过程、转运,登记新生儿详细信息,定期对围产医护人员进行统一培训、考核,反复强化,并进行登记。通过对窒息发生率、新生儿窒息死于分娩现场的发生率、脑瘫发生率比较。结果对照组:窒息发生率为5.05%,新生儿窒息死于分娩现场的发生率为0.65%,脑瘫发生率为0.46%;研究组:窒息发生率为3.27%,新生儿窒息死于分娩现场的发生率为0.16%,脑瘫发生率为0.16%;差异有统计学意义(P<0.05)。结论新生儿窒息复苏新指南应用后新生儿窒息发生率、新生儿窒息死于分娩现场的发生率、脑瘫发生率较前明显下降,效果显著,值得推广。

Objective To improve the success rate of neonatal resuscitation,reduce the rate of death from neonatal asphyxia after delivery and decrease the disability rate.Methods Newborns who suffered neonatal asphyxia were divided into the study group and the control group.The control group was consisted of newborns delivered in our hospital before the cooperation between obstetrics and gynecology and pediatrics during 2000 to 2005.While the study group was composed of newborns delivered in our hospital after the cooperation between obstetrics and gynecology and pediatrics from June 2010 to June 2011.The research group members participated in and instructed the resuscitation of newborns,graded on Apgar,made records of grades,resuscitation process and transfer,registered detailed information of newborns,regularly trained and examined perinatal medical staff,and made comparisons on the asphyxia rate,the rate of death from neonatal asphyxia after delivery and the cerebral palsy rate.Results For the control group,the asphyxia rate was 5.05%,the rate of death from neonatal asphyxia after delivery was 0.65%,and the cerebral palsy rate was 0.46%.As to the study group,the asphyxia rate was 3.27%,the rate of death from neonatal asphyxia after delivery was 0.16%,the cerebral palsy rate was 0.46%,which showed obvious difference（P〈0.05）.Conclusion After the application of the new neonatal resuscitation guidelines,the asphyxia rate,the rate of death from neonatal asphyxia after delivery and the cerebral palsy rate obviously decreased much than before.The new guidelines had significant effects and should be widely spread.