空气复苏与氧复苏在新生儿窒息治疗上的干预效果对比

Comparison of Intervention Effects of Air Resuscitation and Oxygen Resuscitation on neonatal Asphyxia

目的研究对比空气复苏与氧复苏在新生儿窒息治疗上的干预效果。方法研究对象选取为2018年7月至2020年11月在睢县妇幼保健院分娩的110例窒息新生儿。采用随机数表法将其分为空气组和纯氧组,各55例。空气组先进行空气复苏,复苏无效则转为纯氧复苏,纯氧组则直接采用纯氧复苏。观察复苏结果,对比两组新生儿在娩出后1 min、娩出后5 min及娩出后10 min Apgar评分数值。对比两组新生儿的脐动脉血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、pH值、碱剩余(BE)]。对比两组新生儿的脐动脉血血清中的炎性因子指标[高迁移率族蛋白-1(HMGB-1)、白细胞介素-6]。对比两组新生儿娩出5 min时的心率、自主呼吸时间及首次啼哭时间。结果空气组新生儿进行空气复苏成功54例(98.18%),剩余1例转为纯氧复苏,纯氧组所有新生儿均复苏成功。因此将空气组中转为纯氧复苏的1例新生儿数据在后续的对比中从空气组剔除。因此将空气组中转为纯氧复苏的1例新生儿数据在后续的对比中从空气组剔除。两组新生儿娩出后1 min、娩出后5 min、娩出后10 min Apgar评分差异无统计学意义(P>0.05)。两组新生儿脐动脉PaO_(2)、PaCO_(2)、pH值、BE对比差异无统计学意义(P>0.05)。两组新生儿脐动脉血血清HMGB-1、IL-6对比差异无统计学意义(P>0.05)。空气组与纯氧组新生儿娩出5 min时心率对比差异无统计学意义(P>0.05)。但空气组新生儿自主呼吸时间及首次啼哭时间均显著低于纯氧组,差异有统计学意义(P<0.05)。结论空气复苏能够在新生儿窒息的治疗上起到理想的效果,与纯氧复苏相比能够帮助新生儿更快建立自主呼吸功能,值得临床应用。

Objective To study and compare the intervention effect of air resuscitation and oxygen resuscitation on neonatal asphyxia.Methods A total of 110 asphyxiated newborns delivered in Sui County Maternal and Child Health Hospital from July 2018 to November 2020 were selected as the study subjects.They were divided into air group and pure oxygen group with 55 cases each according to the random number table.In the air group,air resuscitation was performed first.If the resuscitation was ineffective,pure oxygen resuscitation was performed.In the pure oxygen group,pure oxygen resuscitation was performed directly.The resuscitative results were observed,and the Apgar scores of newborns in the two groups at 1 min,5 min and 10 min after delivery were compared,the umbilical artery blood gas indexes(PaO_(2),PaCO_(2),pH,BE)of the two groups of newborns were compared.The inflammatory factor indexes[high mobility group box-1(HMGB-1),interleukin-6]in umbilical artery blood serum of the two groups of newborns were compared.The heart rate,spontaneous breathing time and the first crying time of newborns in the two groups at 5 min after delivery were compared.Results 54(98.18%)neonates in the air group were successfully resuscitated,and the remaining one was converted to pure oxygen resuscitation.All neonates in the pure oxygen group were resuscitated successfully.Therefore,the data of one newborn who was converted to pure oxygen resuscitation in the air group were excluded from the air group in the subsequent comparison.There was no significant difference in Apgar scores between the two groups at 1 min,5 min and 10 min after delivery(P>0.05).There was no significant difference in PaO_(2),PaCO_(2),pH and BE of umbilical artery between the two groups(P>0.05).There was no significant difference in serum HMGB-1 and IL-6 between the two groups(P>0.05).There was no significant difference in heart rate between air group and pure oxygen group at 5 min after delivery(P>0.05).However,the spontaneous breathing time and the first crying time in the air group were significantly lower than those in the pure oxygen group(P<0.05).Conclusion Air resuscitation can play an ideal role in the treatment of neonatal asphyxia.Compared with pure oxygen resuscitation,it can help neonates to establish autonomous respiratory function faster,which is worthy of clinical application.