延迟脐带结扎对足月儿影响的meta分析  

Effect of delayed cord clamping in term infants: a meta-analysis

作　　者：余章斌[1] 韩树萍[1] 沙莉[1] 董小玥[1] 陈玉林[1] 邱玉芳[1] 

机构地区：[1]南京医科大学附属南京妇幼保健院儿科,江苏南京210004

出　　处：《临床儿科杂志》2014年第3期278-283,共6页Journal of Clinical Pediatrics

基　　金：江苏省医学重点人才基金资助(No.RC2011021);南京市卫生青年人才基金资助(No.QRX11107)

摘　　要：目的评价延迟脐带结扎（DCC）对足月儿的影响。方法检索Cochrane图书馆、PubMed、EMBASE、中国知网、维普、万方数据库，检索时间均从1970年1月起至2013年4月；对纳入文献进行质量评价，并采用RevMan5.1.0软件进行meta分析。结果共纳入10篇文献，总样本量为1623例。Meta分析结果显示，与立即结扎脐带相比，DCC可以明显提高足月儿出生后血红蛋白的水平（MD=2.19，95％CI：0.36～4.02），对足月儿6个月内血红蛋白的水平没有影响（MD=0.29，95％CI：-0.17～0.75），对足月）L6个月内贫血的发生率没有影响（RR=0.71，95％CI：0.45-1.12），但增加足月儿出生后红细胞增多症的发生率（RR=2.87，95％CI：1.24～6.62），对于高胆红素血症光疗没有影响（RR=2.46，95％CI：0.93-6.52）。结论DCC能改善足月儿出生后的血红蛋白水平；但关于合适的延长时间没有研究进行评价，需要进一步开展高质量、大样本随机对照试验评价合适的DCC的时间。Objective To systematically evaluate the effectiveness of delayed cord clamping （DCC） in term infants. Methods The data of the Cochrane library, PubMed, EMBASE, CNKI, VIP, Wanfang from 1 January 1970 to 30 April 2013 were searched. Randomized controlled trials （RCT） of DCC in term infants were included. RevMan 5.1.0 was used in the statistical analysis. Results Ten studies involving 1623 participants were included. Meta-armlysis based on included studies showed that： compared with immediate cord clamping （ICC）, DCC improved the hemoglobin levels at birth （MD=2.19, 95%CI：0.36, 4.02） and increased the incidence of polycythaemia （RR=2.87, 95%CI：1.24, 6.62）. Compared with ICC, DCC showed no signi- ficant difference in the phototherapy for hyperbilirubinemia （RR=2.46, 95% CI：0.93, 6.52）, the hemoglobin levels within 6 months （MD=0.29, 95%CI：-0.17, 0.75）, and the incidence of anemia （RR=0.71, 95%CI： 0.45, 1.12）. Conclusions DCC can improve the hemoglobin level in term infants after birth. However, the appropriate time of cord clamping has not been determined. It is necessary to undertake further studies with higher quality and larger scale to evaluate the optimal time of cord clamping.

关 键 词：足月儿 延迟脐带结扎 META分析 

分 类 号：R722.1[医药卫生—儿科]