微创胎粪吸引技术在羊水Ⅲ°粪染新生儿中的应用效果

Application effect of minimally invasive meconium aspiration technique in neonates with third-degree fecal staining of amniotic fluid

目的探讨微创胎粪吸引技术在羊水Ⅲ°粪染新生儿中的应用效果。方法选取2019年1~6月于广东医科大学附属海丰县彭湃纪念医院产科分娩羊水Ⅲ°粪染出生后入住新生儿监护室的86例新生儿作为研究对象,采用随机数字表法将其分为观察组(43例)、对照组(43例)。两组均在评估无活力时行胎粪吸引处理,对照组患儿按照普通气管插管接胎粪吸引器吸引治疗,观察组患儿使用微创胎粪吸引技术,即在喉镜下引导吸痰管进入声门进行胎粪吸引处理。比较两组患儿的胎粪吸引次数、操作时间、治疗后临床症状、胸片结果、住院时间、并发症发生情况。结果两组患儿的胎粪吸引次数比较,差异无统计学意义(P>0.05)。观察组患儿的操作时间短于对照组,差异有统计学意义(P<0.01)。两组患儿需要呼吸机辅助通气的占比比较,差异无统计学意义(P>0.05)。观察组患儿的喉头损伤(水肿/出血)占比低于对照组,差异有统计学意义(P<0.05)。两组患儿胸片结果提示胎粪吸入综合征占比及气漏综合征占比比较,差异均无统计学意义(P>0.05)。两组患儿的住院时间比较,差异无统计学意义(P>0.05)。结论对出生后无需气管插管复苏的羊水Ⅲ°粪染无活力新生儿,微创胎粪吸引技术安全有效,操作时间更短,操作后出现喉头损伤等并发症发生率更低。

Objective To explore the application effect of minimally invasive meconium aspiration technique in neonates with third-degree fecal staining of amniotic fluid.Methods A total of 86 newborns admitted to the neonatal intensive care unit after birth with third-degree amniotic fluid in the Department of Obstetrics of Pengpai Memorial Hospital of Haifeng County Affiliated to Guangdong Medical University from January to June 2019 were selected as the research subjects.They were divided into the observation group(n=43)and the control group(n=43)by the random number table method.Both groups underwent meconium aspiration on the assessment of inactivity.In the control group,the common tracheal intubation followed by a meconium aspirator was used,and in the observation group,the minimally invasive meconium aspiration technique was adopted,that was,guiding the suction tube into the glottis under the laryngoscope for meconium suction.The number of meconium suctions,operation time,clinical symptoms after treatment,chest radiograph results,hospitalization time and incidence of complications were compared in the two groups.Results There was no statistically significant difference in the number of meconium suctions between the two groups(P>0.05).The operation time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.01).There was no statistically significant difference in the proportion of requiring ventilator assisted ventilation between the two groups(P>0.05).The proportion of laryngeal injuries(edema or hemorrhage)in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The results of chest radiograph between the two groups indicated that there was no statistical difference in the proportion of meconium aspiration syndrome or the proportion of air leak syndrome(P>0.05).There was no statistically significant difference in hospitalization time between the two groups(P>0.05).Conclusion The minimally invasive meconium suction technique is safe and effective for amniotic fluid third-degree fecal-stained and inactive newborns who do not need tracheal intubation to resuscitate after birth,the operation time is short,and the incidence of complications such as laryngeal injuries after operation is lower.