不同断脐时间对足月儿贫血影响的Meta分析  

Effects of different cord clamping time on anemia in term neonates:a meta-analysis

作　　者：黄蓉[1] 万宏伟[1] 侯燕文[1] 周敏[1] 朱静[1] 朱毓[1] 

机构地区：[1]同济大学附属第一妇婴保健院,上海200040

出　　处：《护理学杂志》2014年第4期81-83,共3页

摘　　要：目的 综合评价早断脐与晚断脐对足月儿贫血、红细胞增多症的影响,为临床选择最佳断脐时机提供依据.方法 通过PubMed、Medline、Cochrane Library、中国生物医学文献数据库、万方数据库、维普资讯等数据库检索关于延迟断脐研究的随机对照试验文献.根据纳入和排除标准对文献进行筛选和质量评价,以RevMan5.1软件进行定量合并分析.结果 共纳入7篇文献进行Meta分析.晚断脐组出生时血红蛋白浓度、出生后2h内红细胞压积、出生后24～48 h血红蛋白浓度均高于早断脐组（SMD为0.76、0.02、1.46）,出生4～6个月时早断脐组铁缺乏症发病风险高于晚断脐组（OR=0.36）；而出生后两组红细胞增多症发病风险无统计学差异（OR=2.61,P＞0.05）.结论 晚断脐是预防婴幼儿贫血的一种较为有效、廉价的途径.Objective To systematically evaluate the effects of early cord clamping versus delayed cord clamping on anemia and poly- cythemia in term neonates, and to provide evidence for clinical workers to select an optimal timing for cord clamping. Methods We searched through Pubmed, Medline, Cochrane Library, CBMdisc, Wanfang Data, and VIP data, etc, to retrieve randomized con- trol trials（RCTs） on delayed cord clamping. The retrieved studies were screened by using inclusion and exclusion criteria, and the quality of selected studies was appraised by 2 reviewers. Then RevMan 5. 1 was used to carry out meta-analysis. Results Seven RCTs were selected to run meta-analysis. The natal hemoglobin concentration（SMD=0. 76）, the red blood cells deposited within 2 hours after birth（SMD=0. 02）, and the hemoglobin concentration 24--48 hours after birth（SMD= 1.46）in the delayed cord clam- ping group were higher than the early cord clamping group. The risk of iron deficiency in the early cord clamping group was higher than the delayed cord clamping group 4--6 months after birth（OR=0.36）. There was no significant difference（OR=2.61,95%CI 0.79~8.61 ,P〉0.05）between the 2 groups in the risk of polycythemia after birth. Conclusion Delayed cord clamping is an effective and low-cost way to prevent anemia in infants.

关 键 词：足月儿 断脐时间 延迟断脐 贫血 红细胞增多症 META分析 

分 类 号：R473.71[医药卫生—护理学]