中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2010年
5期
421-423
,共3页
苏晋琼%朱小瑜%杨传忠%袁世新
囌晉瓊%硃小瑜%楊傳忠%袁世新
소진경%주소유%양전충%원세신
体位引流%气管内吸引%胎粪吸入综合征%窒息%婴儿,新生
體位引流%氣管內吸引%胎糞吸入綜閤徵%窒息%嬰兒,新生
체위인류%기관내흡인%태분흡입종합정%질식%영인,신생
Postural drainage%Endotracheal suction%Meconium aspiration syndrome%Asphyxia%Infants,newborn
目的 评价体位引流辅助气管吸引防治胎粪吸入综合征(MAS)的临床效果.方法 2007年1月至2008年12月我院收治的窒息合并MAS新生儿61例,分为对照组24例,生后气管插管应用胎粪吸引管气管内吸引;观察组37例,插管后体位引流再行气管吸引.主要观察两组气管内吸出胎粪量、MAS并发症及转归.结果 观察组气管内抽出胎粪量(2.16±1.82)ml,较对照组(1. 23±0.97)ml明显增多,差异有显著性(P＜0.05);观察组吸净胎粪所需插管次数为(1.19±0.46)次,较对照组[(1.79±0.83)次]显著减少,差异有显著性(P＜0.01).观察组并发症发生率为8.11%,明显低于对照组29.17%,差异有显著性(P＜0.05).观察组吸氧时间(包括机械通气)为(21.30±22.38)h,较对照组[(52.91±39.20)h]显著缩短,差异有显著性(P＜0.01);观察组住院天数(9.24±3.94)d,对照组为(14.39±6.49)d,差异有显著性(P＜0.01).观察组病死率为0,对照组病死率4.17%,差异无显著性(P＞0.05).观察组1 min Apgar评分与对照组相近,差异无显著性(P＞0.05);观察组5 minApgar评分8～10分者占70.16%,明显高于对照组(58.34%),差异有显著性(P＜0.05).结论 体位引流辅助气管吸引可有效清除气管内胎粪,减少MAS并发症的发生,缩短吸氧时间和住院天数.
目的 評價體位引流輔助氣管吸引防治胎糞吸入綜閤徵(MAS)的臨床效果.方法 2007年1月至2008年12月我院收治的窒息閤併MAS新生兒61例,分為對照組24例,生後氣管插管應用胎糞吸引管氣管內吸引;觀察組37例,插管後體位引流再行氣管吸引.主要觀察兩組氣管內吸齣胎糞量、MAS併髮癥及轉歸.結果 觀察組氣管內抽齣胎糞量(2.16±1.82)ml,較對照組(1. 23±0.97)ml明顯增多,差異有顯著性(P＜0.05);觀察組吸淨胎糞所需插管次數為(1.19±0.46)次,較對照組[(1.79±0.83)次]顯著減少,差異有顯著性(P＜0.01).觀察組併髮癥髮生率為8.11%,明顯低于對照組29.17%,差異有顯著性(P＜0.05).觀察組吸氧時間(包括機械通氣)為(21.30±22.38)h,較對照組[(52.91±39.20)h]顯著縮短,差異有顯著性(P＜0.01);觀察組住院天數(9.24±3.94)d,對照組為(14.39±6.49)d,差異有顯著性(P＜0.01).觀察組病死率為0,對照組病死率4.17%,差異無顯著性(P＞0.05).觀察組1 min Apgar評分與對照組相近,差異無顯著性(P＞0.05);觀察組5 minApgar評分8～10分者佔70.16%,明顯高于對照組(58.34%),差異有顯著性(P＜0.05).結論 體位引流輔助氣管吸引可有效清除氣管內胎糞,減少MAS併髮癥的髮生,縮短吸氧時間和住院天數.
목적 평개체위인류보조기관흡인방치태분흡입종합정(MAS)적림상효과.방법 2007년1월지2008년12월아원수치적질식합병MAS신생인61례,분위대조조24례,생후기관삽관응용태분흡인관기관내흡인;관찰조37례,삽관후체위인류재행기관흡인.주요관찰량조기관내흡출태분량、MAS병발증급전귀.결과 관찰조기관내추출태분량(2.16±1.82)ml,교대조조(1. 23±0.97)ml명현증다,차이유현저성(P＜0.05);관찰조흡정태분소수삽관차수위(1.19±0.46)차,교대조조[(1.79±0.83)차]현저감소,차이유현저성(P＜0.01).관찰조병발증발생솔위8.11%,명현저우대조조29.17%,차이유현저성(P＜0.05).관찰조흡양시간(포괄궤계통기)위(21.30±22.38)h,교대조조[(52.91±39.20)h]현저축단,차이유현저성(P＜0.01);관찰조주원천수(9.24±3.94)d,대조조위(14.39±6.49)d,차이유현저성(P＜0.01).관찰조병사솔위0,대조조병사솔4.17%,차이무현저성(P＞0.05).관찰조1 min Apgar평분여대조조상근,차이무현저성(P＞0.05);관찰조5 minApgar평분8～10분자점70.16%,명현고우대조조(58.34%),차이유현저성(P＜0.05).결론 체위인류보조기관흡인가유효청제기관내태분,감소MAS병발증적발생,축단흡양시간화주원천수.
Objective To evaluate the effect of postural drainage assisting trachea suction on meconium aspiration syndrome. Methods Total 61 cases of asphyxia neonates with MAS who were born in our hospital from Jan,2007 to Dec,2008, were divided into control group (24 cases) and observing group( 37 cases). The neonates in control group had endotracheal suction directly after intubation. But the infant in observing group was treated with endotracheal suction after postural drainage. The amount of suction from endotracheal tube,the complication of MAS and the outcome of these newborns were evaluated. Results The total amount of meconium drainage from endotrachea in observing group was statistics significantly more than that in control group [( 2. 16 ± 1.82) ml vs ( 1.23 ± 0. 97 ) ml, P ＜ 0. 05 )]; The intubating times in observing group were statistical significantly less than that in control group[( 1.19 ± 0. 46) vs ( 1.79 ± 0. 83 ) times, P ＜0. 01 ). The incidence of complication in observing group was 8. 11% ,which was significantly lower than that in control group(29. 17% ,P ＜0. 05). There were shorter needing oxygen time [(21.30 ± 22. 38) h vs (52. 91 ±39. 20) h,P ＜0. 01]and shorter hospitalization days [(9. 24 ±3.94) d vs ( 14. 39 ±6. 49) d,P ＜0.01 )]in observing group than those in control group respectively. The mortality in control group was 4. 17%, and no death occurred in observing group. Apgar scores of the first minute was similar in both groups ( P ＞ 0. 05 ). But there was significant difference(70. 16% vs 58. 34% ,respectively;P ＜0. 05) in the fifth minute Apgar scoring of 8 ～ 10 scores between the observing group and the control group. Conclusion Postural drainage assisting endotracheal suction may remove meconium in trachea effectively, decrease the complications of MAS and shorten the oxygen days and hospitalization time.
