新生儿窒息复苏新指南推广后及加强复苏管理的效果分析

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。

An evaluation of the effects of the new resuscitation guidelines

Objective To evaluate the effects on resuscitation of neonatal asphyxia by promoting the new guidelines and strengthening the management.Methods A retrospective study of 688 newborns with asphyxia from Jan.2005 to Sept.2007 in Zhongshan city was done to evaluate the outcome of promulgation of the new resuscitation guidelines.462 cases that were resuscitated using the old guidelines were served as the control group.And 226 cases that used the new guidelines were recruited in the studied group.Adopting the new Neonatal Resuscitation Guidelines as a standard,we evaluate the outcome and the effects after its application and promulgation.Results(1)In the study group,there is significant improvement(P<0.05)in the extent of neonatal asphyxia vesting encephalopathy than in the control group.(2)There is no difference in the use of masked oxygen and endotrachael intubation in resuscitation.Similarly,external cardiac massage and resuscitation not conforming to the guidelines were less frequent(P<0.05).(3)In the study group,the naloxone and irrational treatment and medications were also significantly less(P<0.05).Conclusion Strengthening management,and promotion of new resuscitation guidelines for neonatal asphyxia should be effectively enforced.