不同起始浓度氧复苏方案对足月新生儿窒息抢救的效果

Effect of different initial concentration oxygen recovery scheme on the neonatal asphyxia

目的探讨不同起始浓度氧复苏方案对足月新生儿窒息的治疗效果。方法选取2015年1月至2016年12月我院产科出生的足月新生儿窒息患儿70例,按照氧复苏起始浓度分为空气组(34例)和中氧组(36例),空气组采用空气(约21%浓度氧)起始复苏,中氧组采用30%氧浓度起始复苏。比较两组患儿氧复苏1、5、10 min的Apgar评分、首次啼哭时间、建立自主呼吸时间、5 min时心率及增氧复苏、脑损伤和复苏成功率。结果氧复苏开始后5、10 min,空气组患儿的Apgar评分低于中氧组(P<0.01)。中氧组患儿的首次啼哭时间和建立自主呼吸时间均早于空气组(P<0.05);治疗5 min时,两组心率比较,差异无统计学意义(P>0.05)。两组患儿均100.0%复苏成功,且中氧组的增氧复苏率低于空气组(P<0.05)。结论采用空气和30%浓氧度起始复苏方案对足月新生儿窒息的疗效相当,安全可靠,均可在临床推广应用,相似条件宜优先采用30%浓度氧方案。

Objective To explore the therapeutic effect of different initial conc entration oxygen recovery scheme on neonatal asphyxia. Methods A total of 70 children with full-term neonatal asphyxia born in obstetrics department of our hospital from January 2015 to December 2016 were selected, and divided into air group（34 cases） and middle oxygen group（36 cases） according to the initial concentration of oxygen recovery. The air group accepted air（about 21% of oxygen concentration） initial recovery; the middle oxygen group received 30% oxygen concentration initial recovery. The Apgar scores at 1, 5 and 10 min of the oxygen recovery, the first cry time, establishment of spontaneous breathing time, the heart rate of 5 min and the rates of oxygenation treatment success, brain injury and recovery in the two groups were compared.Results At 5 and 10 min after the oxygen resuscitation, the Apgar scores in the air group were lower than those in the middle oxygen group（P 〈0.01）. The first time of crying, the establishment of spontaneous breathing time in the middle oxygen group were earlier than those of the air group（P〈0.05）. The heart rates of the two groups at 5 min of treatment were not statistically significant（P〉0.05）. All children of the two groups were successfully resuscitated（100.0%）, and the adding oxygen recovery rate of the middle oxygen group was lower than that of the air group（P〈0.05）. Conclusion The air and 30%oxygen initial resuscitation has consistent effect, both of them are safe and reliable, and 30% oxygen concentration is preferred in the clinical application.