延迟结扎脐带对重度子痫前期患者母婴结局的影响  

Effects of delayed ligation of umbilical cord on maternal and neonatal outcomes in patients with severe preeclampsia

作　　者：谷玉红[1] 黄丽霞[1] 宋菲菲[1] 张彦敏[1] 张红真[1] GU Yuhong, HUANG Lixia, SONG Feifei, ZHANG Yanmin, ZHANG Hongzhen.(Department of obstetrics, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China)

机构地区：[1]河北医科大学第一医院产科

出　　处：《中国妇产科临床杂志》2018年第3期211-213,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：河北省卫生厅科研项目(20130588)

摘　　要：目的探讨延迟结扎脐带对重度子痫前期患者母婴结局的影响。方法采用回顾性研究方法，2013年8月至2016年2月选择在河北医科大学第一医院诊治的重度子痫前期患者78例，根据结扎脐带时间的不同分为观察组48例与对照组30例，对照组分娩后10S内立即结扎脐带，观察组分娩后延迟结扎脐带30~60S，记录两组的母婴结局。结果观察组新生儿的出生后1～3d的血清胆红素含量都明显高于对照组（P〈0．05）。观察组产妇的第三产程时间、产后出血量明显少于对照组（P〈0．05），两组产后第3天的血红蛋白值对比差异无统计学意义（P〉0．05）。观察组新生儿的贫血、输血、高胆红素血症、颅内出血等发生率为10.4％，对照组为33．3％，观察组明显低于对照组（P〈0．05）。观察组新生儿出生后6h和72h的收缩压分别为（73．44±5．53）mmHg和（72．76±4．29）mmHg，都明显高于对照组的（69．82±3．89）mmHg和（70．11±4．29）mmHg（P〈0．05）。结论延迟结扎脐带可提高重度子痫前期患者新生儿的血压水平，有效预防新生儿贫血，减少颅内出血、输血比例，也可缩短产妇的第三产程时间，减少产后出血量。Objective To investigate the effects of delayed ligation of umbilical cord on maternal and neonatal outcomes in patients with severe preeclampsia. Methods Used a retrospective study, from August 2013 to February 2016, 78 cases of severe preeclampsia patients in our hospital were selected and were divided into two groups, the observation group of 48 cases and the control group of 30 cases accorded to the different time of umbilical cord ligation, the control group was given umbilical cord ligation immediately during 10s after delivery, the observation group was given the delayed umbilical cord ligation during 30s-60s after delivery, the maternal and neonatal outcomes in the two groups were recorded, Results The levels of neonatal postpartum 1-3 serum bilirubin in the observation group were significantly higher than those in the control group （P〈O.05） . The maternal third labor time, postpartum hemorrhage in the observation group were significantly less than the control group （P 〈 0.05） , the maternal postpartum 3d hemoglobin value were not significant different （P〉 0.05 ） . The incidence rate of neonatal anemia, blood transfusion, hyperbilirubinemia, intracranial hemorrhage in the observation group was 10.4%, and 33.3% in the control group, the observation group was significantly lower than the control group （P〈 0.05 ） . The neonatal systolic blood pressure of postpartum 6 h and 72h in the observation group were （ 73.44±5.53 ） mm Hg and （ 72.76±4,29） mm Hg, respectively, which were significantly higher than that of the control group of （ 69.82 ± 3.89 ） mm Hg and （ 70.11 ± 4.29） mm Hg （P〈0.05） . Conclusion Delayed ligation of umbilical cord for severe preeclampsia patients can improve the level of blood pressure in neonates, it can effectively prevent the neonatal anemia, blood transfusion, intracranial hemorrhage, and shorten the third labor time and reduce the amount of postpartum hemorrhage.

关 键 词：延迟结扎脐带 重度子痫前期 母婴结局 胆红素 第三产程 

分 类 号：R714.244[医药卫生—妇产科学]