新生儿重度窒息采取延迟断脐带作用研究12例.docVIP

新生儿重度窒息采取延迟断脐带作用研究12例 　　doi：10.3969/j.issn.1007-614x.2014.10.38 摘 要 目的：探讨延迟断脐带与新生儿窒息复苏的效果评价，研究提高新生儿窒息复苏成功率的方法。方法：试验组，将12例重度窒息的新生儿全部采取延迟断脐带；对照组，对同时期生产的12例重度窒息新生儿采取早断脐带，观察复苏成功率、死亡率和后遗症发生率，对新生儿的预后进行统计学分析。结果：延迟断脐带组的复苏成功率高于对照组，死亡率和后遗症发生率低于对照组。结论：延迟断脐带对纠正低血容量、提高复苏成功率、降低死亡率和后遗症发生率有明显作用，对预后有积极影响。 关键词 延迟断脐带 新生儿窒息 复苏预后 The analysis of 12 cases of delayed omphalotomy role of severe neonatal asphyxia Yi Haiyan，Yin Minghua Department of Obstetrical，the Maternal and Child Health Hospital of Wangzhou District，Chongqin 404000 Abstract Objective：To investigate the effectiveness evaluation of delayed omphalotomy in neonatal asphyxia recovery，in order to research the method to improve the success rate of neonatal asphyxia recovery.Methods：12 cases of severe asphyxia of newborn all take delay umbilical cord in the experimental group；12 cases who born with neonatal asphyxia for the same period to take early umbilical in the control group.We observed the success rate of recovery，mortality and the incidence rate of sequelae，and analyzed the prognosis of newborns.Results：The success rate of recovery in the delayed omphalotomy group was higher than the control group，the mortality and incidence rate of sequelae in the delayed omphalotomy group were lower than the control group.Conclusion：The delayed omphalotomy method have obvious effect on correcting hypovolemia，improve success rate of recovery，reduce mortality and the incidence rate of sequelae，and it has a positive impact on the prognosis. Key words Delayed omphalotomy；Neonatal asphyxia；Prognosis of recovery 资料与方法 2010-2012年收治重度窒息新生儿24例，随机分为两组，延迟断脐带组12例，早断脐带组12例。所选新生儿均为足月顺产新生儿，延迟断脐带组产妇年龄20～30岁，产前母体血Hb含量105～122g/L，新生儿体重2.7～3.8kg，阿氏评分0～3分；早断脐带组产妇年龄21～29岁，产前母体血Hb含量110.5～126g，新生儿体重2.65～4.1kg，阿氏评分0～3分。 方法：新生儿娩出前，常规通知儿科医生到场，做好新生儿窒息复苏各项准备工作。延退断脐带组胎儿娩出后，常规清理呼吸道，不急于断脐带，用干毛巾包裹新生儿，在产床治疗台上立即进行窒息复苏，等待胎儿娩出90秒后再断脐带，断脐带后交辐射台继续复苏；早断脐带组常规清理呼吸道后即刻断脐带，交台下窒息复苏，两组胎儿自娩出后采取的复苏措施均按新生儿窒息复苏流程规范进行。所有病例复苏成功后均转NICU治疗观察[1，2]。 结 果 观察和