延迟结扎脐带对足月新生儿及产妇的影响  

Effects of delayed umbilical cord clamping on full-term newborns and maternal outcomes

作　　者：俞涟芳[1] 邵媛仙[1] 项佳华[2] 沈丽芳[2] 潘开宇[1] Yu Lianfang;Shao Yuanxian;Xiang Jiahua;Shen Lifang;Pan Kaiyu(Department of Neonatology,the First People's Hospital of Xiaoshan District,Hangzhou,Zhejiang 311201,China;Department of Obstetrics,the First People's Hospital of Xiaoshan District,Hangzhou,Zhejiang 311201,China)

机构地区：[1]杭州市萧山区第一人民医院新生儿科,311201 [2]杭州市萧山区第一人民医院产科,311201

出　　处：《中国基层医药》2019年第24期2969-2972,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省杭州市科技计划医疗卫生项目(20150633B54)。

摘　　要：目的 探讨延迟结扎脐带对足月新生儿及产妇的影响.方法 选取2017 年1月至2018 年3月在杭州市萧山区第一人民医院产科经阴道分娩的足月新生儿及产妇各287例为观察对象,采用随机数字表法分为对照组141例和观察组146 例.对照组在胎儿娩出后15-20 s内结扎脐带.观察组在胎儿娩出60 s后结扎脐带.比较两组足月新生儿生后3 d静脉血的血红蛋白、红细胞比容、新生儿贫血发生率、新生儿红细胞增多症发生率以及高胆红素血症发生率、光疗时间,比较两组第三产程时间、产妇产后出血量、产后出血发生率.结果 观察组新生儿出生后3 d静脉血血红蛋白[(181.49 ±16.84) g/L]、红细胞比容[(0.545 ± 0.055)]均高于对照组[(175.90 ±17.49) g/L、(0.515 ±0.062)],差异均有统计学意义(t=2.748、3.409,均P<0.05).观察组新生儿贫血发生率为0.68%(1/146),明显低于对照组的4.96%(7/141),差异有统计学意义(χ^2 =4.848,P<0.05).观察组新生儿红细胞增多症发生率为2.05%(3/146),高胆红素血症发生率为24.66%(36/146),光疗时间为(65.50 ±14.63)h,对照组分别为0.17%(1/141)、22.70%(32/141)、(62.09 ± 14.40)h,两组差异均无统计学意义( χ^2 =0.945、0.153, t =0.953,均 P >0.05).观察组第三产程时间[(5.97 ±4.17)min]、产后出血量[(239.04 ±69.15)mL]、产后出血发生率[2.05%(3/146)]与对照组[分别为(5.84 ±3.62) min、(227.73 ±56.99) mL、0.71%(1/141)]相比,差异均无统计学意义( t=0.281、1.504, χ^2 =0.945,均P>0.05).结论 延迟结扎脐带可以提高新生儿血红蛋白、红细胞比容水平,减少新生儿贫血的发生率,不会增加产妇产后出血量.Objective To explore the effects of delayed umbilical cord clamping on full-term newborns and maternal outcomes.Methods From January 2017 to April 2018,287 normal full-term newborns delivered by vagina in the First People's Hospital of Xiaoshan District were selected in the research ,and randomly divided into the control group (141 cases) and observation group (146 cases ) according to the order of entering the delivery room.The control group was ligated the umbilical cord 15-20 s after delivery, while the observation group was ligated the umbilical cord 60 s after delivery.The level of hemoglobin ,hematocrit,the incidence of anemia,polycythemia,hyper-bilirubinemia and phototherapy time of full-term newborns were compared between the two groups 3 days after birth. The third stage of labor, the amount of postpartum hemorrhage and the incidence of postpartum hemorrhage were compared between the two groups.Results The hemoglobin [(181.49 ±16.84) g/L] and hematocrit (0.545 ± 0.055) in the observation group were significantly higher than those in the control group [(175.90 ±17.49 ) g/L, (0.515 ±0.062)] at the third day after birth (t=2.748,3.409,all P<0.05).The incidence of neonatal anemia in the observation group was 0.68%(1/146),which was significantly lower than that in the control group [4.96%(7/141)],and the difference was statistically significant (χ^2 =4.848,P<0.05).The incidence rates of neonatal polycythemia,hyperbilirubinemia and phototherapy time in the observation group were 2.05%(3/146),24.66%(36/146),(65.50 ±14.63)h,respectively,which in the control group were 0.17%(1/141),22.70%(32/141) and (62.09 ±14.40)h,respectively,there were no statistically significant differences between the two groups (χ^2 =0.945,0.153,t=0.953,all P>0.05).The third stage of labor time ,postpartum hemorrhage volume ,incidence of postpartum hemorrhage in the observation group were (5.97 ±4.17)min,(239.04 ±69.15)mL,2.05%(3/146), respectively,which in the control group were (5.84 ±3.62 ) min, (227.73 ±56.99 ) mL,0.71%( 1

关 键 词：脐带 结扎术 时间因素 婴儿 新生 血红蛋白类 贫血 新生儿 红细胞容量 产后出血 妊娠结局 

分 类 号：R47[医药卫生—护理学]