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目的评价新生儿窒息复苏新指南推广及加强复苏管理效果。方法对中山市2005年1月至2007年9月,由乡镇及市区医院分娩转诊到市新生儿急救中心的688例新生儿窒息复苏情况进行回顾分析。采用旧的复苏流程462例为对照组,采用新指南复苏流程226例为研究组,按照《新生儿窒息复苏指南》为标准,对窒息复苏技术应用情况及推广新指南的效果进行评价。结果(1)研究组新生儿窒息的程度、脑病的发生率、脑病的程度及转归均较对照组有明显改善,差异均有统计学意义(P<0.05)。(2)复苏适宜技术的应用,两组比较面罩给氧及气管插管差异无统计学意义,研究组心脏按压及不规范复苏明显减少(P<0.05)。(3)研究组用药、纳洛酮的使用及不合理用药均较对照组明显减少,差异有统计学意义(P<0.01)。结论加强管理、有效推广新生儿窒息复苏新指南,能更好地规范窒息复苏程序、提高复苏效果。
Objective To evaluate the promotion of new guidelines for neonatal asphyxia recovery and to enhance the effectiveness of recovery management. Methods A retrospective analysis was performed on 688 neonates with asphyxia resuscitated from January 2005 to September 2007 in Zhongshan City, which was referred to the City Neonatal Emergency Center by childbirth in townships and urban hospitals. Using 462 cases of old resuscitation procedure as the control group, 226 cases of the new guideline resuscitation procedure were used as the research group. The application of asphyxial resuscitation technology and the effect of promoting the new guideline were evaluated in accordance with the Guidelines for Resuscitation of Neonatal Asphyxia. Results (1) The degree of neonatal asphyxia, the incidence of encephalopathy, the degree and outcome of encephalopathy in study group were significantly improved compared with those in control group (all P <0.05). (2) The application of appropriate resuscitation techniques, there was no significant difference in oxygenation and tracheal intubation between the two groups. The cardiac pressure and non-standard resuscitation in the study group were significantly decreased (P <0.05). (3) The study group medication, the use of naloxone and irrational medication were significantly reduced compared with the control group, the difference was statistically significant (P <0.01). Conclusion Strengthening management and effectively promoting the new guideline of neonatal asphyxia recovery can better regulate the resuscitation procedure and improve the recovery effect.