分娩前运用缩宫素对新生儿黄疸发生率的影响  

Effect of using oxytocin before delivery on the incidence of neonatal jaundice

作　　者：宋秀云 崔芹 王婷婷 SONG Xiu-yun;CUI Qin;WANG Ting-ting(Department of Obstetrics,Jiaozhou Central Hospital,Qingdao,Shandong 266300,China)

机构地区：[1]青岛市胶州中心医院产科,山东青岛266300

出　　处：《中国临床研究》2018年第11期1546-1548,共3页Chinese Journal of Clinical Research

摘　　要：目的探究分娩前缩宫素的运用对新生儿黄疸发生的影响。方法回顾性分析2016年1月至2017年12月于青岛市胶州中心医院经阴道自然分娩产妇的临床资料,选取A组(缩宫素剂量2. 5～5. 0 U)、B组(缩宫素剂量7. 5～10. 0 U)、C组(缩宫素剂量12. 5～15. 0 U)及对照组(产前未给予缩宫素)各360例;对比各组新生儿性别、出生体重、新生儿阿氏(Apgar)评分、神经学-适应能力评分量表(NACS)评分,检测出生后7 d的经皮胆红素值,统计各组病理性黄疸发生率。结果四组新生儿性别、体重、出生后1 min、5 min Apgar评分及出生后15 min时的NACS评分比较无统计学差异(P> 0. 05);但四组新生儿出生后每日经皮测胆红素值比较差异有统计学意义(P <0. 05),且随着剂量增加,经皮测胆红素值上升(P <0. 05);A组、B组、C组及对照组黄疸发生率分别为36. 67%(132例)、45. 56%(164例)、52. 22%(188例)、30. 28%(109例),组间差异有统计学意义(χ2=42. 56,P <0. 01),且随着缩宫素剂量增加,黄疸发生率呈上升趋势。但A组与对照组比较差异无统计学意义(P> 0. 05)。结论分娩前大剂量缩宫素或可增加新生儿黄疸发生风险,临床应合理使用缩宫素,最大限度降低产前缩宫素使用所致的黄疸风险。Objective To investigate the effect of using oxytocin before delivery on the incidence of neonatal jaundice.Methods The clinical data of lying-in women undergoing natural vaginal delivery in Jiaozhou Central Hospital between January 2016 and December 2017 were retrospectively analyzed. According to different doses of oxytocin before delivery,they were divided into group A（2. 5 - 5. 0 U）,group B（7. 5 - 10. 0 U）,group C（12. 5 - 15. 0 U） and control group（not using oxytocin before delivery）（n = 360,each）. The neonatal gender,birth weight,neonatal Apgar scores and neurologic and adaptive capacity scores（NACS） in each group were compared. The transcutaneous bilirubin（Tc B） measurement was performed at 7 days after birth,and the incidence rate of pathological jaundice was calculated. Results There were no significant differences in neonatal gender,weight,Apgar scores at 1-,5-min after birth and NACS score at 15 min after birth among the four groups（all P〉0. 05）. However,there were statistical differences in daily values of Tc B measurement（P〈0. 05）. With the increase of oxytocin dose,Tc B value increased. The incidence of jaundice was 36. 67%（132 cases）,45. 56%（164 cases）,52. 22%（188 cases） and 30. 28%（109 cases） in A-,B-,C-group and control group,respectively,and there were significant differences among four groups（χ^2= 42. 56,P〈0. 01）. With the increase of oxytocin dosage,the incidence of jaundice increased,however,there was no significant difference in it between group A and control group（P〈0. 05）. Conclusion Using high-dose oxytocin before delivery will increase the risk of neonatal jaundice,so oxytocin should be used reasonably to minimize the risk of jaundice in clinic.

关 键 词：黄疸 新生儿 缩宫素 胆红素 阿氏评分 神经学-适应能力评分量表 

分 类 号：R722.17[医药卫生—儿科]