肾上腺素在新生儿重度窒息复苏中的临床应用

目的探讨肾上腺素治疗新生儿重度窒息的临床应用效果。方法将2009年1月至2011年12月重庆市巴南区人民医院抢救的80例重度窒息患儿采用完全随机方法分成两组，对照组40例，采用常规复苏治疗；试验组40例，在常规复苏治疗基础上再给予肾上腺素药物治疗。对两组患者的临床疗效、自主循环时间、自主呼吸时间、生命体征参数以及新生儿阿普加（Apgar）评分、新生儿神经行为测定（NBNA）评分等进行比较与分析。结果试验组的24h生存率、出院生存率、Apgar评分〉7分和NBNA评分〉35分患儿所占比例均显著高于对照组（P〈0．05）；试验组的自主循环和自主呼吸恢复时间显著短于对照组（P〈0．05），试验组的自主循环和自主呼吸维持时间显著长于对照组（P〈0．05）；试验组患儿自主循环恢复后5、15、30、60min的平均动脉压和心率指标水平显著高于对照组（P〈0．05）。结论肾上腺素治疗新生儿重度窒息能促进自主循环和自主呼吸恢复，有效提高生存率。

Clinical Applications of Adrenaline in the Resuscitation of Severe Neonatal Asphyxia

Objective To investigate the clinical efficacy of adrenaline in the resuscitation of severe neonatal asphyxia. Methods The 80 cases of severe asphyxia patients admitted to Chongqing Banan District People＇s Hospital from Jan. 2009 to Dec. 2011 were randomly divided into two groups,control group（ n = 40） and trial group（ n =40）. The control group was given conventional resuscitation, and the trial group was also given adrenaline on the basis of conventional trial. The clinical efficacy, the time of spontaneous circula- tion,spontaneous breathing, vital signs parameter, Apgar score, and NBNA score in 2 groups was observed and compared. Results The 24 h survival rate and the survival rate after discharge,the proportion of Apgar score 〉 7 points and the NBNA score 〉 35 points in the trial group were significantly higher than the control group （P 〈 0.05 ） ; the recovery time of spontaneous circulation, spontaneous breathing in the trial group were significantly shorter than the control group（ P 〈 0.05 ） ;the duration of spontaneous circulation, spontaneous breathing in the trial group were significantly longer than the control group （ P 〈 0.05 ） ; the level of mean arterial pressure and heart rate in the trial group after 5,15,30,60 min return of spontaneous circulation were significantly higher than the control group （ P 〈 0.05 ）. Conchmion Adrenaline in the resuscitation of severe neonatal asphyxia can promote the restoration of spontaneous circulation and spontaneous breathing, and improve the survival rate.