不同浓度氧气对早产儿复苏效果的研究  

Research on different concentrations of oxygen for resuscitation of preterm infants

作　　者：宋志英[1] 杜秀萍[1] 王凌云[1] 曹玉莲[1] SONG Zhi Ying DU Xiu Ping WANG Ling Yun CAO Yu Lian(Maternal and Child Health hospital of ShanXi. Taiyuan 030013, China)

机构地区：[1]山西省妇幼保健院产科,太原030013

出　　处：《中国妇幼卫生杂志》2017年第2期22-25,共4页Chinese Journal of Women and Children Health

基　　金：中国疾病预防控制中心妇幼保健中心新生儿复苏项目-不同氧浓度对早产儿复苏效果的研究(2014FYN005)

摘　　要：目的观察不同浓度氧在早产儿复苏中的有效性。方法本研究为前瞻性单盲随机对照研究。将胎龄≥32周出生的早产儿,经首30 s初步复苏后有正压通气指征的468例患儿纳入研究对象,随机分为两组,A组用21%浓度氧开始复苏,B组用40%浓度氧开始复苏。复苏过程中通过有计划调整氧浓度,使氧饱和度维持在目标范围内。比较两组复苏效果。结果两组有效率比较:1 min时A组为89.2%(156/175),B组为95.2%(279/293),两组比较差异有统计学意义(χ~2=6.177,P<0.05);2min时用21%氧能使SpO_2达到标准值的有效率为A组为97.7%(426/436),B组为需加大氧浓度用40%的氧才能使SpO_2达到标准值的有效率为77.3%(17/22),A、B两组差异有统计学意义(Fish卡方检验,P<0.001);5min时A组为99.8%(457/458),B组为90%(9/10),两组差异有统计学意义(Fish卡方检验,P<0.05);3 min时A组为98.6%(435/441),B组为95.8%(23/24),A、B两组差异无统计学意义(Fisher卡方检验,P>0.05)。结论 (1)早产儿复苏时,起始氧浓度用40%氧复苏效果优于21%氧。出生后一旦肺通气建立,用21%的氧即可将氧饱和度维持达到标准范围。(2)大多数早产儿开始时用21%的氧复苏,也是有效、可行的,尤其是近足月儿。Objective To observe the effectiveness of different concentrations of oxygen on the resuscitation of preterm infants. Methods Prospective single-blind randomized controlled method was used in this study. 468 premature infants who gestational age ≥ 32 weeks and after the first 30s preliminary recovery still had positive pressure ventilation indications were selected as the study objects, and they were divided into two groups randomly, A group （n = 175 patients ） were adopted 21% oxygen concentration to recover, B group （n = 293 patients） were adopted 40% oxygen concentration to recover. In the process of recovery, systematically adjusting oxygen concentration was used to keep oxygen saturation in the target range. The recovery effect between the two groups was compared. Results The effective rate in 1 minute was 89.2% in group A and 95.2% in group B, and the difference was statistically significant （χ^2 = 6. 177, P 〈 0.05 ）. The effective rate in 2 minutes was 97.7% in group A and77.3 % in group B, and the difference was statistically significant （ Fisher chi-square test, P 〈 0. 001 ）. The effective rate in 3 minutes was 98.6% in group A and 95.8% in group B, and the difference was not statistically significant （ Fisher ehi-square test, P 〉 0.05 ）. The effective rate in 5 minutes was 99. 8% group A and 90% in group B, the differences was statistically significant （Fisher chi-square test, P 〈 0.05 ）. Conclusion ①The reeovery effective of 40% oxygen concentration in preterm infants recovery was better than that of 21% oxygen eoneentration. Once pulmonary ventilation established after birth, 21% oxygen concentration can be maintained up to standard. ② The majority of preterm infants recovered with 21% oxygen were effeetive and feasible, especially on the nearly full-term infants.

关 键 词：不同浓度氧 早产儿 正压通气 氧饱和度 

分 类 号：R722.6[医药卫生—儿科]