全麻剖宫产新生儿自主呼吸建立前的干预效果分析

Intervention effects on neonates undergoing uterine-incision delivery under general anesthesia before establishing spontaneously breathing

目的分析小剂量氯胺酮复合咪达唑仑麻醉对剖宫产新生儿呼吸的影响,探讨全麻新生儿尽早建立自主呼吸的措施,并追踪测评全麻后新生儿出生后3、5、15、30 d的NBNA能力。方法保证麻醉诱导10 min内取胎,观察组取胎前吸入5 min 90%~100%氧气,观察组与对照组均在取胎后给予紧闭面罩加压给氧并配合保暖来协助新生儿尽早建立自主呼吸。结果全麻下剖宫产的新生儿进行临床干预处理,复苏成功率明显高于对照组,对NBNA能力测评未发生不良影响。结论对全麻剖宫产新生儿及早进行积极人工干预,取胎前吸入5 min 90%~100%氧气,使其不致于因麻醉药物所致呼吸肌麻痹使自主呼吸建立较晚而影响新生儿的生命及预后,临床效果显著。

Objective To analyze the intervention effects of low-dose ketamine combined with midazolam on respiration of neonates undergoing uterine-incision delivery under general anesthesia before establishing spontaneously breathing,and to explore the NBNA ability of neonates at 3 d,5 d,15 d,30 d after birth. Methods The uterine-incision delivery was carried out within 10 min after anesthesia induction,the pregnant women in observation group were given 90% - 100%oxygen inhalation at 5 min before taking out fetus. After taking out fetus the pregnant women in both groups were given oxygen by face mask pressure combined with keeping body warm to help neonates to estanlish spontaneously breathing as soon as possible. Results After intervention treatment for the neonates undergoing uterine-incision delivery under general anesthesia,the anabiosis success rate in observation group was significantly higher than that in control group. Moreover no adverse effects were observed in evaluation of NBNA ability of neonates. Conclusion It has obvious therapeutic effects to actively interfere the neonates undergoing uterine-incision delivery under general anesthesia with 90% - 100% oxygen inhalation before taking out fetus to help neonates to estanlish spontaneously breathing as soon as possible.