脐带结扎方式对早产儿并发症的影响  

Contribution of different umbilical cord ligation methods to neonatal complications in preterm babies

作　　者：郭芳[1] 朱进秋[1] 罗维真[1] 汤红芳[2] 张霞[1] 李佳[1] 普玲 张静[1] 

机构地区：[1]昆明市妇幼保健院新生儿科,650031 [2]昆明市妇幼保健院产科,650031

出　　处：《中国新生儿科杂志》2014年第6期386-389,共4页Chinese Journal of Neonatology

摘　　要：目的探讨不同脐带结扎方式对早产儿并发症的影响。方法选择2011年9月至2013年12月本院产科顺产出生的早产儿,分别按挤压脐带、延迟脐带结扎及常规脐带结扎三种方法结扎脐带,每组各纳入100例,对3组早产儿出生12～24 h的Hb、Hct和部分并发症发生情况进行比较分析。结果延迟脐带结扎组Hb（g/L）高于挤压脐带组和常规脐带结扎组[（204±25）比（196±16）、（185±12）],挤压脐带组高于常规脐带结扎组;延迟脐带结扎组Hct（%）高于常规脐带结扎组[（67.5±3.0）比（65.9±3.2）],差异有统计学意义（P〈0.05）。挤压脐带组和延迟脐带结扎组发生败血症、坏死性小肠结肠炎（NEC）和贫血的比例均少于常规脐带结扎组（败血症：11%、13%比24%,NEC：6%、5%比15%,贫血：21%、12%比37%）,差异有统计学意义（P〈0.05）,挤压脐带组和延迟脐带结扎组差异无统计学意义（P〉0.05）;各组发生RDS、颅内出血、呼吸暂停、红细胞增多症、高胆红素血症、新生儿出血症、早产儿视网膜病（ROP）、支气管肺发育不良（BPD）的比例差异均无统计学意义（P〉0.05）。挤压脐带组和延迟脐带结扎组住院时间（天）和住院费用（万元）均低于常规脐带结扎组[住院时间：（28.7±1.5）比（32.4±1.3）、（36.2±1.4）,住院费用：（3.1±0.2）比（3.2±0.4）、（3.9±0.3）],挤压脐带组低于延迟脐带结扎组,差异有统计学意义（P〈0.01）。结论挤压脐带和延迟脐带结扎可减少早产儿部分并发症的发生,降低住院时间和费用,易于临床开展,有利于改善早产儿预后。Objective To investigate the effectof different umbilical cord ligation methods to the incidence of neonatal complications in preterm babies. Methods The current study included preterm babies born at the Kunming Maternal and Child Care Hospital from September 2011 to December 2013.Three groups,each consists of 100 infants,were established based on the different umbilical cord ligation methods,i. e. umbilical cord milking（ UCM）,delayed cord clamping（ DCC） or routine cord clamping（RCC）. Hemoglobin（Hb）,hematocrit（Hct）,and incidence of other complications of all the babies12-24 hr of age were compared and subjected to statistical analysis. Results Hb（ g /L） level was significantly higher in the DCC group（204 ± 25） comparing tothe other two groups（ P〈0. 05）; Hb level difference in the UCM group（196 ± 16） and the RCC group（185 ± 12） were also significant（P〈0.05）. Hct（%） level was significantly higher in the DCC group compared to the NCC group[（67. 5 ±3. 0）% vs.（65. 9 ±3. 2）%,P〈0.05]. Compared to infants in the RC group,the incidence of sepsis,NEC and anemia was statistically lower in the DCC and UCM groups（ Sepsis： UMC 11%,DCC 13% vs. RCC 24%; NEC： UMC 6%,DCC 5% vs. RCC 15%; Anemia： UMC21%,DCC12%vs. RCC37%; P〈0. 05）; however,no difference in the rate of sepsis,NEC and anemia occurrence was found in the DCC and UCM groups. In addition,the incidence of RDS,IVH,apnea,polycythemia,hyperbilirubinemia,hemorrhagic disease,ROP and BPD was found without statistical significance in all three groups（ P〉0. 05）. The length of hospital stay（ LOS）（ day） and hospitalization costs（10 000RMB） were significantly lower in the DCC and the UCM groups（LOS： DCC 28. 7 ± 1. 5 UCM 32. 4 ±1. 3,vs. RCC 36. 2 ± 1. 4; Costs： DCC 3. 1 ± 0. 2 UCM 3. 2 ± 0. 4,vs. RCC 3. 9 ± 0. 3）; both the LOS and hospitalization costs were also lower in DCC group when compared to UCM group（P〈0. 01）.Conclusions In premature babies,UmbilicalCord Milking a

关 键 词：胎盘血液循环 胎盘输血 挤压脐带 延迟脐带结扎 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]