早期应用纳洛酮对新生儿重度窒息预后的影响

目的探讨早期应用纳洛酮对新生儿重度窒息的临床价值及对预后的影响。方法选择笔者所在医院2009年3月～2011年3月收治的新生儿重度窒息患儿70例作为研究对象,随机分为观察组和对照组各35例,两组患儿出生后均进行常规初步复苏处理,同时给予加压给氧,胸外心脏按压,脐静脉注射1∶10000肾上腺素0.1mL/kg,其中观察组在上述治疗的基础上给予0.9%氯化钠注射液2mL加纳洛酮0.1mg/kg经脐静脉注入。比较两组的治疗疗效以及纳洛酮对患儿预后的影响。结果经抢救治疗后观察组的总有效率明显高于对照组,差异有统计学意义(P<0.01)。观察组5、10minApgar评分均明显高于对照组(P<0.05)。观察组NBNA评分>35分所占比率明显高于对照组,观察组出现并发症患者5例,对照组出现并发症患者10例,两组并发症发生率比较,差异有统计学意义(P<0.05)。观察组的存活率明显高于对照组,两组患儿的预后比较差异有统计学意义(P<0.05)。结论早期应用纳洛酮抢救治疗新生儿重度窒息疗效确切,能明显改善患儿预后,降低并发症发生率,值得临床推广和应用。

Early application of naloxone for asphyxia neonatal prognosis

Objective To evaluate the early use of naloxone for neonatal asphyxia clinical value,and the prognosis. Methods 70 cases were randomly divided into two groups and the control group,35 patients in every group,two groups of children were routinely after birth preliminary recovery treatment,while giving the pressurized oxygen,external cardiac massage,epinephrine 1 ∶ 10 000 umbilical vein injection of 0.1 mL/kg,of which the treatment group on the basis of the above treatment to 0.9% sodium chloride injection 2 mL Ghana Los ketone 0.1 mg/kg via umbilical vein injection. Observe the effects of treatment were compared,and naloxone on the prognosis of patients. Results After emergency treatment the total effective observation group compared with the control group was significantly higher,the difference was significant(91.4% vs 77.1%,P < 0.01)Observation group 5 min Apgar score,10 min Apgar scores were significantly higher,respectively(P < 0.05). Observation group NBNA score > 35 points was significantly higher than the percentage of the observation group complications were 5 cases in the control group 10 patients with complications,complication rate between the two groups,the difference was significant(14.3%VS28.6%,P < 0.05).The survival rate was significantly higher than the observation group,the prognosis of children with differences between the two groups was significant(P < 0.05). Conclusion Early application of naloxone in emergency treatment of severe neonatal asphyxia is effective,patients can significantly improve prognosis,reduce the complication rate,and it is worthy of promotion and application.