高原地区健康足月新生儿生后30分钟内血氧饱和度、心率变化研究  

Study on the changes of oxygen saturation and heart rate in healthy full-term newborns in plateau area during the first 30 minutes after birth

作　　者：夏成[1] 陈大鹏 刘勤 刘英[1] 让四吉 周晓燕 冯艺 XIA Cheng;CHEN Dapeng;LIU Qin;LIU Ying;RANG Siji;ZHOU Xiaoyan;FENGYi(Ganzi Tibetan Autonomous Prefecture People's Hospital, Kangding 626000, Sichuan, China;West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610000, Sichuan, China;The People’s Hospital of Kangding, Kangding 626000, Sichuan, China)

机构地区：[1]甘孜藏族自治州人民医院儿科,四川康定626000 [2]四川大学华西第二医院新生儿科出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610000 [3]康定市人民医院急诊科,四川康定626000

出　　处：《临床儿科杂志》2019年第7期485-488,共4页Journal of Clinical Pediatrics

基　　金：四川省卫生和计划生育委员会科研课题(No.150061);四川省科技厅应用基础研究项目(No.2011JY0085);成都市科技局攻关项目(No.12PPYB003SF-002)

摘　　要：目的探讨高原地区健康足月新生儿在出生后 1 ~ 30分钟内血氧饱和度(SpO 2)及心率(HR)的变化情况。方法采用脉氧饱和度仪持续测定不同海拔地区 194例正常足月新生儿在生后 1 ~ 30分钟的 SpO 2及 HR,描绘生后 1 ~ 30分钟的 SpO 2及 HR的 P 5 ~P 95图表,并比较不同分娩方式、性别及不同海拔地区新生儿的差异。结果生后 1分钟,新生儿平均 SpO 2为(59± 4)%,平均 HR为(135± 13)次/min,之后 SpO 2逐渐上升, 5分钟时达 80 %, 10分钟时上升至 89 %, 15分钟后稳定在 95 %左右。 HR在生后 2分钟后稳定在 175次/min左右。出生 1 ~ 15分钟,不同海拔地区新生儿的 SpO 2差异均有统计学意义(P< 0 . 001);随海拔升高 SpO 2降低,这种差异在生后 20分钟及以后消失。生后 1 ~ 30分钟,不同海拔地区新生儿的 HR差异均有统计学意义(P< 0 . 001),海拔越高 HR越高。不同分娩方式新生儿出生 1 ~ 30分钟 SpO 2和 HR随时间变化的趋势有所不同(F= 2 . 45、 2 . 09, P均< 0 . 05),但不同性别之间SpO 2和 HR随时间变化的趋势类似(P> 0 . 05)。结论随着海拔增高,新生儿出生后 1 ~ 10分钟的 SpO 2可略低于窒息复苏指南推荐的 SpO 2,且上升至 90 %所需时间延长;海拔越高,新生儿HR越高。在高原地区进行窒息复苏时应结合临床表现,谨慎用氧,避免高氧损害。Objective To explore the changes of blood oxygen saturation (SpO2) and heart rate (HR) in healthy full-term neonates in plateau area within 1 to 30 minutes after birth. Method The SpO2 and HR of 194 normal full-term newborns at different altitudes were continuously measured by pulse oximeter 1~30 minutes after birth, and the 5th ~ 95th percentile charts of SpO2 and HR at 1~30 minutes after birth were drawn. The differences were compared among different delivery modes, sexes and altitudes in newborns. Results One minute after birth, the average SpO2 and HR of newborns were 59%±4% and 135±13 times/min. Then SpO2 gradually increased, reaching 80% at 5 minutes, 89% at 10 minutes and stabilizing at about 95% at 15 minutes. HR stabilized at about 175 times/min 2 minutes after birth. The SpO2 differences of newborns at different altitudes were statistically significant from 1 to 15 minutes after birth (P< 0.001). With the increase of altitude, SpO2 of newborns decreased, and the difference disappeared after 20 minutes. The HR of newborns at different altitudes had significant difference from 1 to 30 minutes after birth (P<0.001), and the the HR increased over the altitude. The trend of SpO2 and HR changes over time from 1 to 30 minutes after birth was different in different delivery modes (F=2.45, 2.09, P< 0.05), but they were similar between different genders (P>0.05). Conclusion As the altitude increases, the SpO2 from 1 to 10 minutes after birth could be slightly lower than the SpO2 recommended by the asphyxia resuscitation guide, and and it takes longer to rise to 90%. The neonatal HR was lower at the higher altitude. In the plateau area, the performance of asphyxia recovery should be combined with the clinical manifestations, and oxygen should be used cautiously to avoid high oxygen damage.

关 键 词：氧饱和度 心率 高原 新生儿 

分 类 号：R722.1[医药卫生—儿科]