纳美芬对新生儿重度窒息复苏效果的影响

Effect of nalmefene on resuscitation result of severe asphyxia in the newborn

目的 探讨纳美芬对新生儿重度窒息复苏效果的影响。方法 选择2013年6月至2014年12月,手术室剖宫产产出后1 min（T_0）诊断为重度窒息的新生儿46例,随机分为2组,每组23例。同样的急救复苏流程后,观察组给予纳美芬治疗,对照组给予等量生理盐水,两组分别于首次用药后5 min（T_1）、15 min（T_2）和30 min（T_3）行Apgar评分,记录需辅助正压通气的例数和用时,观察用药3 d内的病情变化。结果 两组Apgar评分在T_1~T_3时均高于T_0（P〈0.01）,观察组在T_1~T_3时高于对照组（P〈0.05）;观察组需辅助正压通气用时较对照组缩短（P〈0.05）;治疗3 d内,观察组原始反射异常和肌张力降低发生率均低于对照组（P〈0.05）,两组惊厥和死亡发生率比较差异无统计学意义（P〉0.05）。结论 纳美芬对新生儿重度窒息复苏的近期效果确切,呼吸恢复快,在某种程度上可以减轻脑缺氧损伤而改善预后。

Objective To investigate the effect of newborn. Methods Totally 46 cases diagnosed as severe nalmefene on resuscitation result of severe asphyxia in the asphyxia in the newborn at 1 rain after cesarean delivery （TO ） from June 2013 to December 2014 were randomly divided into 2 groups ,23 cases in each group. After the same emergency resuscitation process, patients in observation group received nalmefene treatment while control group re- ceived the equal volume of normal saline. The Apgar score was recorded respectively at 5 min （Tl ） , 15 min（ T2 ） and 30 min（ T3 ） after the first medication. The frequency and the time of auxiliary positive pressure ventilation was also re- corded. The changes in pathogenetic condition during 3 d of medication were observed. Results The Apgar scores at T1 - T3 were higher than that at TO （ P 〈 0. 01 ）, and the scores in observation group were higher than those of control group at T1 - T3 （ P 〈 0. 05 ）. The time of auxiliary positive pressure ventilation in observation group was shorter than that of control group（ P 〈 0. 05 ）. The incidence of abnormal primitive reflex and decrease of muscle tone in observation group were lower than those of control group within 3 d of medication （ P 〈 0. 05 ）, while no significant difference was found in convulsion and death rate between the two groups （ P 〉 0. 05 ）. Conclusion Nalmefene has certain recent effect on resuscitation result of severe asphyxia in the newborn with fast breathing recovery, and it can improve the cer- ebral anoxia damage, thus improving the prognosis.