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目的:分析羊水污染与新生儿窒息关系,提出预防措施。方法:回顾分析406例羊水污染致新生儿窒息的临床资料。结果:2009年1月-12月平顶山市妇幼保健院孕37-42周住院分娩产妇2 100例,被羊水污染406例,羊水污染率为19.33%(406/2 100),新生儿窒息60例,窒息率为14.78%(60/406);自然分娩、剖宫产与阴道助产其Ⅰ、Ⅱ、Ⅲ度羊水污染差异有统计学意义(χ2值分别为6.35、33.71和98.17,P值分别为0.042、0.000 0和0.000 0),重度窒息、吸入性肺炎和缺氧缺血性脑病差异有统计学意义(χ2值分别为29.85、10.73和73.40,P值分别为0.000 0、0.005和0.000 0)。结论:新生儿窒息与羊水污染密切相关,Ⅲ度羊水污染是剖宫产指征,Ⅰ、Ⅱ度羊水污染是重点监护对象,一旦出现异常情况尽快结束分娩,以降低新生儿窒息发生率。
Objective: To analyze the relationship between amniotic fluid pollution and neonatal asphyxia and propose preventive measures. Methods: Retrospective analysis of 406 cases of amniotic fluid pollution caused by neonatal asphyxia clinical data. Results: From January to December 2009, there were 2 100 cases of maternal hospitalization in Maternity and Child Care Hospital of Pingdingshan during 37-42 weeks of pregnancy, 406 cases of amniotic fluid contamination, 19.33% (406/2 100) cases of amniotic fluid contamination, 60 cases of neonatal asphyxia , And asphyxia rate was 14.78% (60/406). There were significant differences in amniotic fluid contamination between spontaneous delivery, cesarean section and vaginal delivery in I, II and III degrees (χ2 = 6.35, 33.71 and 98.17, respectively 0.042, 0.000 and 0.000 0), severe asphyxia, aspiration pneumonia and hypoxic-ischemic encephalopathy were statistically significant (χ2 = 29.85,10.73 and 73.40, P = 0.000 0,0.005 and 0.000 0 respectively ). Conclusion: Neonatal asphyxia is closely related to amniotic fluid pollution. Ⅲ degree amniotic fluid is the indication of cesarean section. Amniotic fluid contamination of Ⅰ and Ⅱ degrees is the key monitoring target. Once the abnormal situation occurs, delivery ends as soon as possible to reduce the incidence of neonatal asphyxia.