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40%氧浓度复苏对窒息新生儿复苏效果、脑损伤和氧中毒并发症的影响

Effect of oxygen resuscitation at a concentration of 40% on resuscitation, brain injury and oxygen poisoning in asphyxiated neonates

    摘要
  • 摘要:
      目的  探讨40%氧浓度复苏对窒息新生儿临床症状、脑损伤和氧中毒并发症的影响。
      方法  回顾性分析80例窒息新生儿的临床资料，根据氧复苏浓度的不同分为空气复苏组35例和40%氧浓度组45例，其他基础复苏治疗和护理措施均相同，复苏后转至新生儿科监护室。观察2组窒息新生儿开始啼哭时间、建立自主呼吸时间和出生后1、5、10 min的Apgar评分，比较2组复苏成功率、脑损伤和氧中毒并发症情况。
      结果  2组复苏成功率均为100.00%, 无死亡病例; 40%氧浓度组新生儿开始啼哭时间、建立自主呼吸时间均短于空气复苏组，差异有统计学意义(P < 0.05); 2组新生儿出生1 min Apgar评分比较，差异无统计学意义(P>0.05), 40%氧浓度组出生后5、10 min Apgar评分分别为(7.72±1.23)、(6.68±1.37)分，高于空气复苏组的(6.68±1.37)、(8.78±0.84)分，差异有统计学意义(P < 0.05); 40%氧浓度组复苏后2~3 d的新生儿神经行为测定(NBNA)评分高于空气复苏组，脑损伤发生率低于空气复苏组，差异有统计学意义(P < 0.05); 2组新生儿氧中毒发生率比较，差异无统计学意义(P>0.05)。
      结论  40%氧浓度和空气氧浓度复苏均有满意的窒息新生儿复苏成功率，但前者在改善新生儿窒息临床症状和预防脑损伤方面更具优势，且并不增加氧中毒并发症。

     

    Abstract:
      Objective  To investigate the effect of oxygen resuscitation at a concentration of 40% on resuscitation, brain injury and oxygen poisoning in asphyxiated neonates.
      Methods  The clinical data of 80 asphyxiated newborns admitted to our hospital were retrospectively analyzed. They were divided into air resuscitation group (n=35) and 40% of oxygen concentration group (n=45) according to different oxygen concentrations, given the same other basic resuscitation treatments and nursing, and were transferred to neonatal care unit after resuscitation. The time to first crying, time to establishment of spontaneous breathing and the Apgar score at 1, 5 and 10 min after birth of asphyxiated newborns in the two groups were observed. The success rate of resuscitation, complications such as brain injury and oxygen poisoning were compared between the two groups.
      Results  The success rate of resuscitation was 100.00% in both groups, and there were no deaths. The time to first crying and the time to establishment of spontaneous breathing in 40% of oxygen concentration group were shorter than those in air resuscitation group (P < 0.05). There was no significant difference in Apgar score at 1 min after birth between the two groups (P>0.05). Apgar scores at 5 and 10 min after birth in 40% of oxygen concentration group were (7.72±1.23) and (6.68±1.37) points, respectively, which were significantly higher than (6.68±1.37) and (8.78±0.84) points, respectively, in air resuscitation group(P < 0.05). The Neonatal Behavioral Neurological Assessment (NBNA) score at 2 to 3 days after resuscitation in 40%of oxygen concentration group was higher, and the incidence of brain injury was lower than that of air resuscitation group (P < 0.05). There was no significant difference in the incidence of neonatal oxygen poisoning between the two groups (P>0.05).
      Conclusion  Oxygen resuscitation at a concentration of 40% and air oxygen concentration resuscitation both have satisfactory resuscitation success rate of asphyxiated neonates, but the former has more advantages in improving clinical symptoms of neonatal asphyxia and preventing brain injury, and does not increase complications of oxygen poisoning.

     

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