分娩过程中脐带挤压对早产儿脑损伤的影响  

Effect of umbilical cord milking in labor on cerebral injury of premature infants

作　　者：李光忠 刘细萍 罗卫娟 胡彩云 刘江萍 LI Guangzhong;LIU Xiping;LUO Weijuan;HU Caiyun;LIU Jiangping(Department of Pediatrics,Luxi County People’s Hospital in Pingxiang City,Pingxiang,Jiangxi,337220)

机构地区：[1]江西省萍乡市芦溪县人民医院儿科,江西萍乡337200

出　　处：《实用临床医药杂志》2020年第15期115-118,共4页Journal of Clinical Medicine in Practice

基　　金：江西省卫生健康委科技计划(20204552)。

摘　　要：目的探讨出生时挤压脐带(UCM)对早产儿脑损伤的影响。方法选取45例早产儿作为研究对象,按随机数字表法分为出生时立即结扎脐带(ICC)组、延迟脐带结扎(DCC)组、UCM组,每组15例。比较3组早产儿的血常规及胆红素指标、脑损伤及神经系统后遗症情况。结果出生24 h时及出生7 d后,DCC组与UCM组早产儿的红细胞(RBC)、血红蛋白(Hb)、红细胞压积(HCT)水平均高于ICC组,差异有统计学意义(P <0.05);出生后6、12、24、48、72 h,3组间经皮胆红素比较,差异无统计学意义(P> 0.05);DCC组、UCM组的出生窒息发生率及窒息程度均低于ICC组,缺氧缺血性脑病、脑出血、输血及神经系统后遗症的发生率均低于ICC组,住院时间均短于ICC组,差异有统计学意义(P <0.05)。结论 UCM可有效改善早产儿的血容量,减少脑损伤以及神经后遗症的发生,安全性较高。Objective To investigate the effect of umbilical cord milking(UCM)at birth on cerebral injury of premature infants.Methods Totally 45 premature infants were selected and randomly divided into immediate cord clamping(ICC)group,delayed cord clamping(DCC)group and umbilical cord milking(UCM)group,with 15 cases in each group.The blood routine indexes,bilirubin index,cerebral injury condition and neurologic sequelae condition were compared among the three groups.Results At 24 h and 7 d after birth,the levels of red blood cell(RBC),hemoglobin(Hb)and hematocrit(HCT)in the DCC group and the UCM group were significantly higher than those in the ICC group(P<0.05).At 6,12,24,48,72 h after birth,there was no significant difference in transcutaneous bilirubin level among the three groups(P>0.05).In the DCC group and the UCM group,the incidence and severity of birth asphyxia,the incidence rates of hypoxic-ischemic encephalopathy,cerebral hemorrhage,blood transfusion and neurological sequelae,and hospital stay were significantly better than those in the ICC group(P<0.05).Conclusion UCM can effectively improve the blood volume of premature infants,reduce the incidence of cerebral injury and neurologic sequelae,and safety is relatively high.

关 键 词：早产儿 脑损伤 挤压脐带 血红蛋白 胆红素 神经后遗症 

分 类 号：R722.6[医药卫生—儿科]