摘要
目的:分析产前催产素使用时限与剂量对新生儿黄疸程度的影响。方法:选取2019年2月至2020年3月青岛市胶州中心医院产科经阴分娩孕妇1320例,其中570例分娩前使用催产素记为实验组,其余750例分娩前未使用催产素记为对照组,比较两组产妇娩出后脐血血清总胆汁酸(TBA)、新生儿出生后4d内经皮胆红素变化,记录两组新生儿黄疸发生率,同时比较实验组中各亚组(按催产素使用时限分为催产素使用1~2h组、3~4h组、4~5h组,按催产素使用剂量分为5~10U组、11~16U组、>16U组)新生儿黄疸发生率、经皮胆红素水平。结果:实验组产妇娩出后脐血TBA水平明显高于对照组(P<0.05);实验组新生儿出生后第1天、第2天、第3天、第4天经皮胆红素高于对照组(P<0.05);实验组新生儿病理性黄疸、生理性黄疸及黄疸总发生率高于对照组(P<0.05);实验组中,催产素使用3~4h组产妇娩出的新生儿黄疸发生率及出生后4d内经皮胆红素低于催产素使用1~2h组、4~5h组产妇娩出的新生儿(P<0.05);实验组中,催产素使用剂量为5~10U组、11~16U组的产妇娩出的新生儿黄疸发生率低于16U组产妇娩出的新生儿(P<0.05);催产素使用剂量为11~16U组、>16U组产妇娩出的新生儿出生后第2天、第3天、第4天经皮胆红素高于5~10U组产妇所娩出的新生儿(P<0.05)。结论:产前应用催产素可能增加新生儿黄疸风险,尤其是催产素使用剂量>16U的产妇新生儿黄疸发生率高,催产素使用时限控制在3~4h、使用剂量为11~16U对新生儿黄疸的影响最小。
Objective:To analyze the effect of medication time and dose of oxytocin on the severity of neonatal jaundice.Methods:A total of 1,320 pregnant women who underwent vaginal delivery in Jiaozhou Central Hospital from September 2019 to April 2020 were enrolled.Among them,570 cases treated with oxytocin before delivery were included in experimental group and 750 oxytocin-free cases were included in control group.The changes of maternal umbilical cord serum total bile acid(TBA)after delivery,and neonatal transcutaneous bilirubin within 4d after birth were compared between the two groups.The incidences of neonatal jaundice in both groups were recorded.Meanwhile,the incidences of neonatal jaundice and transcutaneous bilirubin levels were compared among subgroups of the experimental group(pregnant women in the experimental group were divided into oxytocin use 1~2 h group,3~4 h group and 4~5 h group according to the medication time of oxytocin,and they were divided into 5~10U group,11~16U group and>16U group according to the dose of oxytocin used).Results:The maternal umbilical cord blood TBA levels in experimental group were significantly higher than those in the control group after delivery(P<0.05).On the 1st,2nd,3rd and 4th day after birth,neonatal percutaneous bilirubin levels in experimental group were higher than those in control group(P<0.05).The incidences of neonatal pathological jaundice and physiological jaundice and total incidence of jaundice in experimental group were higher than those in control group(P<0.05).In experimental group,the incidences of jaundice and percutaneous bilirubin within 4d after birth in neonates born by puerperae in 3~4 h group were lower than those born by 1~2 h group and 4~5 h group(P<0.05).The incidences of jaundice in neonates born by puerperae in 5~10 U group and 11~16 U group were lower than those born by>16 U group(P<0.05).On the 2nd,3rd and 4th day after birth,percutaneous bilirubin in neonates born by puerperae in 11~16 U group and>16 U group was higher than 5~10 U group(P<0.05).Conclusion:Prenatal application of oxytocin may increase the risk of neonatal jaundice,and the incidence of neonatal jaundice is relatively higher in puerperae with oxytocin dose higher than 16U.Besides,the effect of oxytocin medication time of 3~4 h and dose of 11~16 U is the least.
作者
朱同娥
张靖靖
李修敏
ZHU Tong'e;ZHANG Jingjing;LI Xiumin(Qingdao Jiaozhou Central Hospital,Shandong Qingdao 266300,China)
出处
《河北医学》
CAS
2020年第10期1668-1673,共6页
Hebei Medicine
基金
山东省青岛市卫生科技计划项目,(编号:2018-WJZD077)。
关键词
催产素
使用时限
剂量
血清总胆汁酸
经皮胆红素
新生儿黄疸
Oxytocin
Medication time
Dose
Serum total bile acid
Transcutaneous bilirubin
Neonatal jaundice
