延迟脐带结扎对早产儿短期结局影响的系统评价  

Systematic evaluation on effect of delayed umbilical cord ligation on short-term outcome of premature infants

作　　者：郭敏 王翠[1] 张楠[1] 王功朝[1] GUO Min;WANG Cui;ZHANG Nan;WANG Gongchao(Shandong Provincial Hospital Affiliated to Shandong University, Shandong 250021 China)

机构地区：[1]山东大学附属省立医院

出　　处：《护理研究》2019年第8期1298-1304,共7页Chinese Nursing Research

基　　金：山东省自然科学基金项目;编号:ZR2015HM066

摘　　要：[目的]系统评价延迟脐带结扎对早产儿短期结局的影响。[方法]计算机检索国内外有关延迟断脐对早产儿短期结局影响的随机对照试验。严格质量评价后,采用RevMan 5.3软件进行分析。[结果]最终纳入15篇文献,共1 060例病人。Meta分析结果表明,延迟断脐可以提高早产儿出生后24h内的红细胞比容[MD=4.94,95%CI(3.54,6.33),P<0.000 01]和血红蛋白水平[MD=20.24,95%CI(12.15,28.34),P<0.000 01],降低输血率[OR=0.34,95%CI(0.16,0.72),P=0.005],降低脑室内出血[OR=0.68,95%CI(0.47,0.96),P<0.05]和新生儿坏死性小肠结肠炎发生率[OR=0.59,95%CI(0.36,0.97),P<0.05],且不提高血清胆红素峰值[MD=0.17,95%CI(-0.52,0.87),P>0.05]。[结论]与早期断脐相比,延迟断脐有益于早产儿的短期结局。Objective: To systematically evaluate the effect of delayed umbilical cord ligation on short term outcome of premature infants. Methods: The domestic and foreign randomized controlled trials on the effect of delayed umbilical cord ligation on short term outcomes of premature infants were searched by computer. After strict quality evaluation,the RevMan 5.3 software was used for analysis. Results: Finally,15 articles were included,with a total of 1 060 patients.Meta analysis results showed that delayed umbilical cord ligation could improve the RBCs of premature infants within 24 h after birth[MD=4.94, 95% CI (3.54, 6.33), P <0.000 01]and hemoglobin level[MD=20.24,95% CI (12.15, 28.34), P <0.000 01],reduce blood transfusion rate [OR=0.34,95% CI (0.16, 0.72), P = 0.005],and reduce intraventricular hemorrhage[OR=0.68,95% CI (0.47, 0.96), P <0.05].Incidence of necrotizing enterocolitis in neonates[OR=0.59,95% CI (0.36, 0.97), P <0.05]and serum bilirubin peak were not increased [MD=0.17,95% CI (-0.52,0.87), P > 0.05]. Conclusion: Compared with early umbilical cord ligation,delayed umbilical cord ligation is beneficial to the short-term outcome of premature infants.

关 键 词：系统评价 延迟断脐 早产儿 红细胞比容 血红蛋白 输血 脑室内出血 新生儿坏死性小肠结肠炎 

分 类 号：R47[医药卫生—护理学]