体位引流在清理新生儿呼吸道中的作用

Roles of Postural Drainage in the Clearing of Respiratory Tract of Newborns

目的探讨体位引流在刚分娩新生儿清理呼吸道中的作用。方法选择2010年6～12月在宜兴市人民医院阴道分娩的足月新生儿600例。随机分为研究组和对照组,每组300例。研究组使用头低足高位体位引流的基础上配合手法挤压口鼻的方法清理新生儿呼吸道,对照组使用手法挤压加吸痰管吸引的方法。结果研究组清理呼吸道时间明显短于对照组;且大部分能一次性清理干净呼吸道,而无需再使用吸痰管吸引。新生儿窒息率明显少于对照组,新生儿早吸吮较对照组提前,且早吸吮增加,研究组无一例发生羊水吸入综合征(均P<0.05),有统计学意义。结论体位引流配合手法挤压能借助重力作用,可使新生儿呼吸道分泌物排出更迅速有效,大大减少对新生儿使用吸痰管吸引等缺氧性损伤性操作,减少羊水吸入,降低新生儿窒息率。

Objective To discuss and analyze the use of postural drainage in the clearing of respiratory tract of newborns. Methods 600 cases of mature newborns during June to December 2010 from vaginal delivery in Yixing People＇s Hospital were selected and distributed into research group or control group randomly,300 cases in each group. The research group were put in the foot-high horizontal position to carry out the postural drainage and manual press and massage for mouth and nose to clear the respiratory tract,while mu- cous extractor plus manual press and massage for mouth and nose were used for the control group. Results The clearing time for the research group was obviously shorter than for the control group. Mostly, the clearing of the respiratory tract can be done at one time to avoid the use of mucous extractor. The rate of asphyxia of newborns of the research group was significantly lower than the rate of the control group. The newboms of the research group suck earlier than the ones of the control group. Moreover, there was no case of amnionic fluid aspiration syndrome in the research group,with statistical significance（ all P 〈 0.05 ）. Conclusion Manural press and massage for mouth and nose combined with the foot-high horizontal position may benefit from gravi- ty action and be more effective in clearing the respiratory tract of newborns, markedly reducing the anoxic damage fromor using mucous extractor,the amniotie fluid aspiration and the rate of asphyxia of newborns.