高原地区健康足月新生儿生后30 分钟内血氧饱和度、心率变化研究

临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (7): 485-.doi: 10.3969/j.issn.1000-3606.2019.07.002

• 心血管系统疾病专栏 • 上一篇下一篇

高原地区健康足月新生儿生后30 分钟内血氧饱和度、心率变化研究

夏成 1，陈大鹏 2，刘勤 1，刘英 1，让四吉 1，周晓燕 3，冯艺 2

1.甘孜藏族自治州人民医院儿科（四川康定　626000）；2.四川大学华西第二医院新生儿科　出生缺陷与相关妇儿疾病教育部重点实验室（四川成都　610000）；3.康定市人民医院急诊科（四川康定　626000）

发布日期:2019-07-18
通讯作者: 冯艺　电子信箱：fengyi06029123@163.com
基金资助:
四川省卫生和计划生育委员会科研课题（No.150061）；四川省科技厅应用基础研究项目（No.2011JY0085）；成都市科技局攻关项目（No.12PPYB003SF-002）

Study on the changes of oxygen saturation and heart rate in healthy full-term newborns in plateau area during the first 30 minutes after birth

XIA Cheng, CHEN Dapeng, LIU Qin, et al

1.Ganzi Tibetan Autonomous Prefecture People's Hospital, Kangding 626000, Sichuan, China; 2. West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610000, Sichuan, China; 3. The People’s Hospital of Kangding, Kangding 626000, Sichuan, China

Published:2019-07-18

摘要/Abstract

摘要： 　目的　探讨高原地区健康足月新生儿在出生后1~30分钟内血氧饱和度（SpO2）及心率（HR）的变化情况。方法　采用脉氧饱和度仪持续测定不同海拔地区194例正常足月新生儿在生后1~30分钟的SpO2及HR，描绘生后1~30分钟的SpO2及HR的P5~P95图表，并比较不同分娩方式、性别及不同海拔地区新生儿的差异。结果　生后1分钟，新生儿平均SpO2为（59±4）%，平均HR为（135±13）次/min，之后SpO2逐渐上升， 5分钟时达80%，10分钟时上升至89%，15分钟后稳定在95%左右。HR在生后2分钟后稳定在175次/min左右。出生1~15分钟，不同海拔地区新生儿的SpO2差异均有统计学意义（P<0.001）；随海拔升高SpO2降低，这种差异在生后20分钟及以后消失。生后1~30分钟，不同海拔地区新生儿的HR差异均有统计学意义（P<0.001），海拔越高HR越高。不同分娩方式新生儿出生1~30分钟SpO2和HR随时间变化的趋势有所不同（F=2.45、2.09， P均<0.05），但不同性别之间SpO2和HR随时间变化的趋势类似（P>0.05）。结论　随着海拔增高，新生儿出生后1~10分钟的SpO2可略低于窒息复苏指南推荐的SpO2，且上升至90%所需时间延长；海拔越高，新生儿HR越高。在高原地区进行窒息复苏时应结合临床表现，谨慎用氧，避免高氧损害。

关键词: 　氧饱和度；　心率；　高原；　新生儿

Abstract: Objective　To explore the changes of blood oxygen saturation (SpO2) and heart rate (HR) in healthy full-term neonates in plateau area within 1 to 30 minutes after birth. Method　The SpO2 and HR of 194 normal full-term newborns at different altitudes were continuously measured by pulse oximeter 1~30 minutes after birth, and the 5th ~ 95th percentile charts of SpO2 and HR at 1~30 minutes after birth were drawn. The differences were compared among different delivery modes, sexes and altitudes in newborns. Results　One minute after birth, the average SpO2 and HR of newborns were 59%±4% and 135±13 times/min. Then SpO2 gradually increased, reaching 80% at 5 minutes, 89% at 10 minutes and stabilizing at about 95% at 15 minutes. HR stabilized at about 175 times/min 2 minutes after birth. The SpO2 differences of newborns at different altitudes were statistically significant from 1 to 15 minutes after birth (P< 0.001). With the increase of altitude, SpO2 of newborns decreased, and the difference disappeared after 20 minutes. The HR of newborns at different altitudes had significant difference from 1 to 30 minutes after birth (P<0.001), and the the HR increased over the altitude. The trend of SpO2 and HR changes over time from 1 to 30 minutes after birth was different in different delivery modes (F=2.45, 2.09, P< 0.05), but they were similar between different genders (P>0.05). Conclusion　As the altitude increases, the SpO2 from 1 to 10 minutes after birth could be slightly lower than the SpO2 recommended by the asphyxia resuscitation guide, and and it takes longer to rise to 90%. The neonatal HR was lower at the higher altitude. In the plateau area, the performance of asphyxia recovery should be combined with the clinical manifestations, and oxygen should be used cautiously to avoid high oxygen damage.

Key words: oxygen saturation;　heart rate;　plateau;　newborn

夏　成，陈大鹏，刘　勤，等. 高原地区健康足月新生儿生后30 分钟内血氧饱和度、心率变化研究[J]. 临床儿科杂志, 2019, 37(7): 485-.

　XIA Cheng1, CHEN Dapeng2, LIU Qin1, LIU Ying1, RANG Siji1, ZHOU Xiaoyan3, FENG Yi2. Study on the changes of oxygen saturation and heart rate in healthy full-term newborns in plateau area during the first 30 minutes after birth[J]. Journal of Clinical Pediatrics, 2019, 37(7): 485-.

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