延迟脐带结扎后胎盘侧残余血量变化的研究  

Study on the change of residual placental blood volume in delayed cord clamping

作　　者：翁豪勇 吴燕[2] 黄梦真 陈雪敏[1] 羊玉坤 黄思华 凌奕[1] 徐霞 张宏玉[1] 

机构地区：[1]海南医学院,海口571119 [2]海南省海口市妇幼保健院,571101

出　　处：《中国妇幼卫生杂志》2017年第4期87-90,共4页Chinese Journal of Women and Children Health

基　　金：海南医学院大学生创新课题<实施晚断脐后胎盘侧残余血量变化的研究>(HYCX2015066)提供资助

摘　　要：目的比较新生儿延迟脐带结扎和早断脐从胎盘侧能够采集到的残余血量,避免过早采集脐带血对新生儿造成伤害。方法将海口市妇幼保健院2015年3-6月经阴道分娩的403例足月正常新生儿作为研究对象,随机分为观察组(n=202)和对照组(n=201)。延迟脐带结扎等待脐带搏动停止后,早断脐在产后1分钟时断脐,采集胎盘侧的残血并记录。结果延迟脐带结扎组胎盘侧的残血量(14.12±12.40)m L,少于早断脐组(69.049±50.02)m L(t=15.112,P<0.01),新生儿胆红素高峰平均值(11.84±3.24)mg/d1低于早断脐组(16.31±1.93)mg/d1(t=4.900,P<0.01),产后出血量(160.24±72.90)m L低于早断脐组(187.77±104.62)m L(t=3.063,P=0.002),差异均有统计学意义。结论延迟脐带结扎,从胎盘侧收集的残血量减少,提示有更多血液输给了新生儿,具有临床应用价值。Objective Exploring the difference of residual placental blood volume between delayed cord clamping and early cord clamping, to avoid the potential harm on newborns by too early to cut the cord. Methods From Mar. to Jun. in 2015 in Haikou maternal and child health hospital, 403 cases vaginal birth with vertical term single normal baby were enrolled and randomized to two groups, study group（n = 202 ） adapted delaying cord clamping until the pulsation of the cord artery ceased, control group （n = 201 ） adapted cutting the cord within 60 second. Residue blood in the umbilical cord was collected from the placental size in both groups. Results Residual placental blood volume in study group [ （ 14. 12 ± 12.40 ） mL ] was less than that in control group [ （ 69. 049 ±50. 02） mL] （ t = 15.112, P 〈 0.01 ） ; the peak level of bilirubin [ （ 11.84± 3.24） mg/dl ] in study group was lower than that in control group [ （ 16. 31 ± 1.93 ） mg/dl ] （t = 4. 900 P 〈 0.01 ） ; postpartum blood loss [ （ 160.24 ± 72.90）mL ] in study group was less than that in control group [ （ 187.77 ± 104.62 ） mL ]（ t = 3. 063 , P = 0.002 ）, and the differences were all statistically significant. Conclusions Delayed cord clamping until the secession of the umbilical artery pulsation reduces the residual placental blood volume, that suggests more placental transfusion to the newborns which is evidenced with clinical practical values.

关 键 词：延迟脐带结扎 早断脐 胎盘新生儿输血 胎盘侧残余血量 产后出血 

分 类 号：R722.1[医药卫生—儿科]