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不同氧浓度对新生儿窒息复苏脑损伤的影响

         

摘要

Objective To discuss the clinical effects of different oxygen concentrations during neonatal asphyxiation recovery.Methods 120 full-term newborns with asphyxia treated in the Sixth People's Hospital of Nanning City from February 2016 to February 2017 were selected.The newborns were randomly divided into the air resuscitation group,low concentration oxygen group and high concentration oxygen group,each group had 40 cases.The air resuscitation group was treated with air resuscitation,high concentration oxygen group was treated with 100% oxygen resuscitation,and low concentration oxygen group was treated with 30% oxygen resuscitation.The time of began to cry and spontaneous breathing establishment,Apgar scores at different time after birth,recovery success rate and recovery safety of the three groups were compared.Results There were statistically significant differences in the time of began to cry and the time of spontaneous breathing establishment among the three groups (P < 0.05),of which the air resuscitation group and low concentration oxygen group were all shorter than the high concentration oxygen group,with statistically significant differences (P < 0.05),the low concentration oxygen group were shorter than the air resuscitation group,but no statistically significant differences (P > 0.05).There were statistically significant differences in Apgar scores at different time after birth among the three groups (P < 0.05),of which the air resuscitation group and low concentration oxygen group were higher than the high concentration oxygen group,with statistically significant differences (P < 0.05),the low concentration oxygen group were higher than the air resuscitation group,but no statistically significant differences (P > 0.05).The incidence of neonatal brain injury of the air resuscitation group and low concentration oxygen group were lower than those of the high concentration oxygen group,with statistically significant differences (P <0.05),while the low concentration oxygen group was lower than the air resuscitation group,but no statistically significant difference (P > 0.05).The successful rate of recovery was 100.00% in three groups.The incidence of oxygen poisoning of the air resuscitation group and low concentration oxygen group were lower than those of the high concen tration oxygen group,with statistically significant differences (P < 0.05),while the low concentration oxygen group was lower than the air resuscitation group,but no statistically significant difference (P > 0.05).Conclusion During the course of neonatal asphyxia resuscitation,30% oxygen resuscitation is effective,which can achieve better recovery effect,effectively reduce brain damage and avoid the emergence of oxygen poisoning.It is a more safe and effective recovery program.%目的 探讨新生儿窒息复苏过程中应用不同氧浓度的临床效果.方法 选择2016年2月~2017年2月南宁市第六人民医院收治的120例足月新生儿,均出现窒息现象,随机分为空气复苏组、低浓度氧气组、高浓度氧气组,每组各40例.空气复苏组采用空气复苏,高浓度氧气组实施100%氧复苏,低浓度氧气组实施30%氧复苏.比较三组开始啼哭时间与建立自主呼吸时间、新生儿出生后不同时间的Apgar评分及复苏成功率和复苏安全性.结果 三组新生儿开始啼哭时间与建立自主呼吸时间比较差异有统计学意义(P<0.05),其中,空气复苏组和低浓度氧气组时间显著短于高浓度氧气组(P<0.05),低浓度氧气组时间短于空气复苏组,但差异无统计学意义(P>0.05).三组新生儿出生后不同时间Apgar评分差异有统计学意义(P<0.05),其中,空气复苏组和低浓度氧气组不同时间评分均显著高于高浓度氧气组(P<0.05),低浓度氧气组评分高于空气复苏组,但差异无统计学意义(P>0.05).空气复苏组和低浓度氧气组新生儿脑损伤发生率均显著低于高浓度氧气组(P<0.05),低浓度氧气组脑损伤发生率低于空气复苏组,但差异无统计学意义(P>0.05).三组患儿复苏成功率均为100.00%.空气复苏组和低浓度氧气组患儿氧中毒发生率均显著低于高浓度氧气组(P<0.05),低浓度氧气组氧中毒发生率低于空气复苏组,但差异无统计学意义(P>0.05).结论 新生儿窒息复苏过程中实施30%氧复苏效果显著,可以获得更好的复苏效果,有效减少脑损伤,并减少中毒的出现,是一种更为安全有效的复苏方案.

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