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目的探索纳络酮进行胎儿宫内窘迫的可行性。方法将进入临产状态确诊为胎窘的孕妇90例随机分为两组,纳洛酮组45例,静脉缓慢推注纳洛酮0.4mg+50%葡萄糖60mL加维生素C 500mg;对照组45例,静脉缓慢推注50%葡萄糖60mL加维生素C 500mg。观察两组胎心率的变化,终止妊娠的方式及终止妊娠时采集脐静脉血作血气分析及新生儿Apgar评分等。结果纳洛酮组胎心率显著增加,剖宫产率37.7%,血气分析表明酸中毒不同程度的改善,1min Apagar评分(7.2±0.51),5min Apagar评分(8.3±2.3),10min Apagar评分(9.5±1.8)。对照组胎心率略增加,剖宫产率64.4%,血气分析表明酸中毒未能得到改善,1min Apagar评分(6.4±1.15),5min Apagar评分(7.3±3.4),10minApagar评分(8.9±0.53)。结论纳络酮能有效地提高胎儿宫内缺氧的耐受性,在治疗胎儿宫内窘迫时行之有效。
Objective To explore the feasibility of naloxone for fetal distress. Methods Ninety pregnant women who were admitted to labor with confirmed fetal distress were randomly divided into two groups: naloxone group (n = 45), naloxone 0.4mg + 50% glucose (60mL plus vitamin C 500mg), control group (n = 45) Slow intravenous injection of 50% glucose 60mL plus vitamin C 500mg. The change of fetal heart rate, the way of terminating pregnancy and the umbilical vein blood collected during the termination of pregnancy were analyzed for blood gas analysis and neonatal Apgar score. Results Fatal heart rate increased significantly in naloxone group, with a 37.7% rate of cesarean section. Blood gas analysis showed different degrees of improvement in acidosis, Apagar score of 1 minute (7.2 ± 0.51), Apagar score of 5 minutes (8.3 ± 2.3), Apagar score of 10 minutes 9.5 ± 1.8). Fetal heart rate was slightly increased in the control group, with a cesarean section rate of 64.4%. Blood gas analysis showed that acidosis did not improve, Apagar score at 1 minute (6.4 ± 1.15), Apagar score at 5 minutes (7.3 ± 3.4), and Appenizar score at 10 minutes (8.9 ± 0.53) . Conclusion Naloxone can effectively improve the tolerance of fetal intrauterine hypoxia and is effective in the treatment of fetal distress.