脐静脉注射盐酸纳美芬对轻度窒息新生儿复苏的影响  

Influence of Navel Vein Injected Hydrochloride Nalmefene on the Resuscitation of Mild Degree Asphyxia Neonates

作　　者：赵兰花[1] 邓军[2] 韦桂红[1] 赵红金[1] 黄慧群 李艺[1] ZHAO Lan-hua;DENG Jun;WEI Gui-hong;ZHAO Hong-jin;HUANG Hui-qun;LI Yi(Baise Maternity&Child Healthcare Hospital,Baise Guangxi 533000,China;Department of Anesthesiology,Affiliated Hospital of YouJiang University for Nationalities,Baise Guangxi 533000,China)

机构地区：[1]百色市妇幼保健院,广西百色533000 [2]右江民族医学院附属医院麻醉科,广西百色533000

出　　处：《医学食疗与健康》2020年第13期4-6,9,共4页Medical Diet and Health

基　　金：百色市科学技术局资助科研项目(百科计20183316);百色市科学技术局资助科研项目(百科计20201726)。

摘　　要：目的:研究脐静脉注射盐酸纳美芬对非剖宫产轻度窒息新生儿复苏的影响。方法:100例非剖宫产轻度窒息新生儿随机分为纳美芬组和纳络酮组。断脐后,两组新生儿分别通过脐静脉注射4μg/mL纳美芬5mL或40μg/mL纳络酮5mL。他们按2015美国新生儿复苏指南进行复苏。接生助产士分别在新生儿出生时(T0)、出生后5分钟(T1)和出生后10分(T2)进行新生儿Apgar评分。记录两组新生儿Apgar评分、窒息例数、气管插管带管时间以及新生儿重症室(NICU)停留时间。结果:①T1时Apgar评分和T2时Apgar评分组间比较,Z值是2.10和2.74(P<0.05),有统计学意义。②T1、T2时新生儿窒息例数组间比较,χ2值分别是4.84和5.32(P<0.05),有统计学意义。③纳美芬组气管插管带管时间和NICU停留时间短于纳络酮组,t值分别是9.96和4.16,有统计学意义。结论:纳美芬能高效、持续拮抗新生儿呼吸抑制,降低新生儿窒息率和气管插管率,缩短气管插管带管时间和NICU停留时间,提高新生儿复苏质量,改善新生儿结局。Objective:To study the influence of navel vein injected hydrochloride nalmefene on the resuscitation of mild degree asphyxia neonates born by non cesarean section.Methods:100 mild degree asphyxia neonates that born by non cesarean section were randomly divided into the nalmefene group and the naloxone group.After broken umbilical,these neonates in both groups were respectively injected with 5 ml nalmefene(4μg/mL)or 5 mL naloxone(40μg/mL)via umbilical vein.These neonates in both group were all resuscitated according to the 2015 American neonatal resuscitation guideline.Midwives performed and recorded neonatal Apgar scores in both groups at birth(T0),5 minutes after birth(T1)and 10 minutes after birth(T2),respectively.The neonatal asphyxia number cases,duration of endotracheal intubation,and staying-time in neonatal intensive care unit(NICU)wererespectively recorded.Results:①Apagar scores at T1 between groups comparison and Apagar scores at T2 between groups comparison,Z value were respectively 2.10 and 2.74(P<0.05).The difference in above was statistically significant.②The neonatal asphyxia number cases at T1 and the neonatal asphyxia number cases at T2 between groups comparison,χ2 value were respectively 4.84 and 5.32(P<0.05).The difference from above was statistically significant.③Duration of entotracheal intubation in the nalmefene groups and staying-time in neonatal intensive care unit(NICU)in the nalmefene groups were respectively shorter than in the naloxone.t value between groups comparisonwere respectively 9.96 and 4.16(P<0.05).this was statistically significant.Conclusion:Nalmefene could high effectively and continuously reduce the respiratory depression of neonates,decrease the rate of neonatal asphyxia and the rate of endotracheal intubation.It could also shorten the duration of endotracheal intubation and NICU staying-time,ameliorate the quality of neonatal resuscitation and neonatal outcomes.

关 键 词：纳美芬 新生儿窒息 APGAR评分 复苏质量 新生儿结局 

分 类 号：R742[医药卫生—神经病学与精神病学]