对阴道分娩新生儿不进行口鼻咽吸引的效果研究  

The effects of no routine oronasopharyngeal suction on outcomes in neonates delivered vaginally

作　　者：於雅娜 闫晓峰[1] 庞景 章佩 张洪霞 YU Yana;YAN Xiaofeng;PANG Jing;ZHANG Pei;ZHANG Hongxia(Department of OB-Inpatient,Beijing United Family Hospital,Beijing,100015,China)

机构地区：[1]北京和睦家医院妇产科,北京市100015

出　　处：《中华护理杂志》2018年第9期1029-1034,共6页Chinese Journal of Nursing

摘　　要：目的探讨足月正常阴道分娩的新生儿不常规进行口鼻咽吸引对新生儿结局的影响。方法采用多中心随机对照法,选取在北京市3所医院分娩的足月正常阴道分娩的新生儿326例作为研究对象,随机分为实验组和对照组。实验组159例,在新生儿头部娩出后不使用手法挤压口鼻,全身娩出后,仅使用布巾擦拭面部,不常规进行口鼻咽吸引;对照组167例,分娩过程中和娩出后分别使用手法挤压口鼻,再使用吸引球吸引口鼻咽,必要时加用吸引管。结果两组新生儿建立正常呼吸用时,出生后1 min、5 min、10 min的Apgar评分、心率、呼吸频率、血氧饱和度,出生后90 min内再吸引、再复苏、需要及转入新生儿重症监护室或新生儿病房的发生率比较,差异无统计学意义(P>0.05);两组新生儿第1次觅食征象出现时间、开始含接乳头时间和开始吸吮时间比较,差异有统计学意义(P<0.05)。两组中有羊水污染的新生儿正常呼吸建立时间>30 s的例数比较,实验组少于对照组,差异有统计学意义(P<0.05);其他指标差异均无统计学意义。结论足月正常阴道分娩的新生儿,分娩时可以不使用手法挤压口鼻和不常规进行口鼻咽吸引。Objective To evaluate the effects of no routine oronasopharyngeal suction on the outcomes in vigor- ous full-term neonates delivered vaginally. Methods Using multicenter randomized controlled trail,326 vigorous full-term neonates delivered vaginally in 3 hospitals in Beijing were randomly assigned to the experimental and the control groups. For 159 neonates in the experimental group,neonates received no manual squeeze on the mouth and nose after the head delivery,and there was no routine oronasopharyngeal suction and only wiping on the face;for 167 neonates in the control group,neonates received manual squeeze on the mouth and nose before the shoulder delivered and after the whole body delivered,oronasopharyngeal suction by bulb syringe and using negative pressure suction tube if necessary. Results There were no statistically differences （P〉0.05） in normal breathing established time and Apgar scores,heart rates,respiratory rates,hemoglobin oxygen saturation levels by Pulse oximetry（SpO2） on 1 min,5 rain and 10 rain and the incidence of re-suction needs,resuscitation needs in 90 rain and NICU or Neonatal ward admissions between two groups. The first feeding cues appeared time,latch on time and sucking time showed statistically significant differences（P〈0.05） between two groups. Further analysis between meconium stained neonates in two groups showed significant difference （P〈0.05） in the incidence of normal breathing established time〉30 seconds （the experimental group was less than the control group）;there were no statistically significant differences in other indexes. Conclusion For vigorous full-term neonates,there is no need for squeezing mouth,nose and routine orona- sopharyngeal suction.

关 键 词：新生儿护理 口鼻咽吸引 呼吸道清理 自然分娩 多中心 随机对照试验 

分 类 号：R473.72[医药卫生—护理学]