早产儿/低出生体重儿应用国产喉罩复苏的效果分析  

Effect Analysis of Resuscitation of Domestic Laryngeal Mask for Premature Infants/Low Birth Weight Infants

作　　者：赖春华[1] 高建慧[1] 陈志君[1] 陈翠瑶 陈昂[1] 陈广明[1] 杨冰岩[1] LAI Chunhua;GAO Jianhui;CHEN Zhijun;CHEN Cuiyao;CHEN Ang;CHEN Guangming;YANG Bingyan(Zhongshan Boai Hospital/Zhongshan Maternal and Child Health Hospital Zhongshan 528403,China;不详)

机构地区：[1]中山市博爱医院//中山市妇幼保健院,广东中山528403

出　　处：《现代医院》2020年第6期903-906,910,共5页Modern Hospitals

基　　金：中山市科技计划项目(20132A012)。

摘　　要：目的探讨早产儿/低出生体重儿应用国产喉罩复苏的可行性、有效性和安全性。方法选择2013年4月1日-2016年10月31日在中山市博爱医院∥中山市妇幼保健院出生,孕周30~34周或出生体重1500~2000 g的早产儿/低出生体重儿,需要正压通气73例,随机分为国产喉罩组和面罩组,比较复苏效果。结果①喉罩成功置入时间(9.81±2.71)s,一次成功置入率90.3%;②国产喉罩组与面罩组复苏成功比例为83.9%与54.7%(P=0.009),复苏起效时间为(26.04±21.21)s与(48.87±19.4)s(P<0.05),通气时间为(46.89±39.88)s与(85.87±48.36)s(P<0.05);国产喉罩组改气管插管率为16.1%,明显低于面罩组的26.2%(P=0.024)。③5 min Apgar评分>7分者国产喉罩组多于面罩组(P=0.038)。④两组复苏成功新生儿血气分析PH、PCO2、BE、乳酸的差值均无差异,国产喉罩组复苏前后PO2差值比面罩组高(P<0.05)。结论国产喉罩气道操作简单,应用于早产儿/低出生体重儿复苏安全、有效,与面罩相比,能更快建立有效通气、减少气管插管率,且价格相对较低,适合在基层医疗机构推广使用。Objective To investigate the feasibility,effectiveness and safety of domestic laryngeal mask in resuscita-tion for premature/low birth weight infants.Methods 73 newborns,who are the premature with gestational age of 30-34weeks or low birth weight infants with weight of 1500-2000 g born in Boai Hospital of Zhongshan City from April 1,2013 to October 31,2016,needing positive pressure breathing after their birth,were randomly divided into domestic laryngeal mask and facial mask group,observing the the resuscitation effect.Apgar scores at 1 and 5 minutes,blood gas analysis re-sults.Results①the successful placement time of laryngeal mask was(9.81±2.71)seconds,and the one-time successful placement rate was 90.3%.②the successful rate of resuscitation in domestic laryngeal mask group and facial mask group was 83.9%and 54.7%,respectively(P=0.009);the onset time of resuscitation were(26.04±21.21)and(48.87±19.4)seconds,respectively(P<0.05);and the ventilation time were(46.89±39.88)and(85.87±48.36)seconds,respec-tively(P<0.05).The rate of tracheal intubation in the domestic mask group was 16.1%,significantly lower than that in the facial mask group(26.2%)(P=0.024).③Apgar score at 5min(>7)was higher in the domestic laryngeal mask group than in the facial mask group(P=0.038).④there were no differences in blood PH,PCO2,BE and lactic acid for these two groups after successful neonatal resuscitation,and the difference between PO2 before and after resuscitation was larger in the domestic laryngeal mask group than in the facial mask group(P<0.05).Conclusion The domestic laryngeal mask is easy to operate,safe and effective for resuscitation in premature/low-birth-weight infants.Compared with the facial mask,domes-tic laryngeal mask can establish effective ventilation faster,reduce the rate of tracheal intubation,and have a relatively low price.Therefore,domestic laryngeal mask is suitable for promotion in primary medical institutions.

关 键 词：喉罩 新生儿窒息 复苏 婴儿 早产 

分 类 号：R722.12[医药卫生—儿科]