足月新生儿窒息时复苏采用氧浓度与脑损伤的相关性  

Relationship between different oxygen concentration and thebrain injury of full-term newborn recover from asphyxia

作　　者：梁明姬 马国哲 韩芳[1] 李春华[1] 

机构地区：[1]惠州市第三人民医院儿科,广东惠州516000 [2]中信惠州医院,广东惠州516000

出　　处：《热带医学杂志》2016年第8期1033-1036,共4页Journal of Tropical Medicine

基　　金：惠州市科技计划项目(2013y151)

摘　　要：目的探讨足月新生儿脑损伤与窒息时复苏采用氧浓度的关系。方法选取窒息但无脑损伤的足月新生儿240例为研究对象并采用数字随机法分为低氧浓度组(21%氧浓度复苏)、中氧浓度组(40%氧浓度复苏)和高氧浓度组(100%氧浓度复苏),每组80例。患儿复苏前后均行头颅MRI检查并以出现苍白球或底丘脑异常信号为脑损伤诊断标准诊断三组脑损伤发生情况,比较三组复苏效果并分析足月新生儿脑损伤与窒息时复苏采用的氧浓度的关系。结果与低氧浓度组比较,中氧浓度组和高氧浓度组脑损伤发生率降低,开始啼哭时间和建立自主呼吸时间缩短,出生后5 min和10 min的新生儿Apgar评分和Pa O2升高(P<0.05)。高氧浓度组和中氧浓度组脑损伤发生率以及复苏效果相关指标比较差异无统计学意义(P>0.05)。中氧浓度组出生后5 min和10 min的Pa O2低于高氧浓度组(P<0.05)。Logistic分析结果显示,足月新生儿脑损伤与窒息时复苏采用的氧浓度密切相关。结论窒息时中等氧浓度(40%)窒息复苏效果更有利于Pa O2提高,因此临床上可采用中等氧浓度以安全有效地提高疗效并预防足月窒息新生儿脑损伤的发生。Objective To explore the relationship different oxygen concentration and the brain injury of full-term newborn recover from asphyxia. Methods 240 cases of full-term newborn with asphyxia but no brain damage were selected as the research object and divided into low oxygen concentration group（21% oxygen concentration recovery）, medium oxygen concentration group（40% oxygen concentration recovery） and high oxygen concentration group（100% oxygen concentration recovery） by the digital random method, 80 cases in each group. Children were performed head MRI exam before and after the recovery and signal abnormal pallidum or subthalamic were taken as standard for brain damage diagnosis.The relationship between different concentration of oxygen and the brain injury of full-term newborn recovered from asphyxia was analyzed. Results Compared with low oxygen concentration groups, brain injury rate of the medium oxygen concentration group and high oxygen concentration group were reduced; start crying time and the establishment of spontaneous breathing time of the medium oxygen concentration group and high oxygen concentration group were shortened, while the 5 min and 10 min after birth newborn Apgar score and Pa O2 of the medium oxygen concentration group and high oxygen concentration group were higher（P 〈0.05）. brain injury rate, start crying time, the establishment of spontaneous breathing time and 5 min and 10 min after birth newborn Apgar score of high oxygen concentration groups and medium oxygen concentration group had no statistical significant difference（P 0.05）. 5 min and 10 min after birth Pa O2 of the medium oxygen concentration group were lower than those of the high oxygen concentration group（P 〈0.05）.Logistic analysis results showed that the full-term neonatal brain injury recovered from asphyxia was closely related to the oxygen concentration. Conclusion Asphyxia recovery by medium oxygen concentration（40%） had higher blood gas oxygen partial pressure, therefore, the medium oxygen

关 键 词：足月 新生儿 脑损伤 窒息 氧浓度 复苏 

分 类 号：R722.12[医药卫生—儿科]