产程中静滴缩宫素对新生儿黄疸的影响

马霞霞，李红梅

(延安大学附属医院妇产科，陕西延安716000)

摘要：新生儿黄疸是常见的新生儿疾病，其发生受多种因素的影响，若不及时处理会引起严重并发症。缩宫素是临床上常用子宫收缩药物，主要用于引产、催产及产后和流产后的子宫出血。许多研究表明孕妇产程中使用缩宫素会导致新生儿黄疸的发生率增高，可能因缩宫素的抗利尿作用引起孕妇、新生儿血液渗透压下降，红细胞破坏增多，导致胆红素代谢异常。而且临床使用缩宫素多用5%葡萄糖溶液稀释，若使用不当会引起孕妇水中毒，新生儿血钠水平下降，低渗状态使红细胞变形性减低，红细胞破坏增多，新生儿黄疸发生率增加。另外，新生儿黄疸发生率与缩宫素有剂量-时间关系，剂量超过一定量时，黄疸发生率则上升。因此探讨缩宫素与新生儿黄疸的作用机制有很重要的临床的意义。本文对产程中静滴缩宫素对新生儿黄疸的影响机制进行综述。

关键词：新生儿黄疸；缩宫素；影响机制

中图分类号：R722

作者简介：马霞霞(1989—)，女，陕西延安人，硕士研究生在读，研究方向：围产医学。

[收稿日期2014-12-15；责任编辑梁毅]

The effect of oxytocin infusion in labor on neonatal jaundice

MAXia-xia,LIHong-mei

(Affiliated Hospital of Yanan university,Yanan 716000,China)

Abstract：Neonatal jaundice is a common neonatal disease which is influenced by many factors, and it can cause serious influence on newborns if can't be treated in time. Oxytocin is mainly used for induced labor, hasten parturition and postpartum hemorrhage, which is an effective initiator of uterine contractions. Many researches have shown that using of oxytocin in labor could increase the incidence of neonatal jaundice. It is the antidiuretic function of oxytocin that can make decreased the plasma osmotic pressure of pregnant women and newborn and increased erythrocyte destruction, and clinical hyperbilirubinaemia ensues. Furthermore, oxytocin is used with 5% glucose solution in clinic, and the unreasonable use can cause pregnant women water intoxication and neonatal hyponatremia which make decreased erythrocyte deformation index (EDI) and increased erythrocyte destruction and incidence of neonatal jaundice. In addition, there is a time-related and dose-related effect of oxytocin on neonatal jaundice. When the dose of oxytocin exceeds a certain amount, the incidence of jaundice can rise. Therefore, to study the effect of oxytocin on neonatal jaundice has very important clinical significance.This is a review about the mechanism of oxytocin in labor and neonatal jaundice.

Key words：Neonatal jaundice; Oxytocin; Mechanism

新生儿黄疸亦称新生儿高胆红素血症，是指新生儿期由于胆红素代谢异常引起血中胆红素水平升高而出现皮肤、黏膜和巩膜黄染的临床现象。诊断标准为一旦经皮胆红素测定值>220.6 μmol/L(12.9 mg/d)或胆红素每天上升5 mg/dl，视为高胆红素血症[1]。新生儿黄疸是新生儿时期常见疾病，可见于50%以上足月儿和80%以上早产儿。大……