不同脐带挤勒方式对早产儿贫血的早期影响  

Intact-versus cut-umbilical cord milking in preterm infants:a randomised controlled trial

作　　者：谢雨婕 王蓓[2] 张永红[1] 王依闻 谭金童 谢利娟[1] Xie Yujie;Wang Bei;Zhang Yonghong;Wang Yiwen;Tan Jintong;Xie Lijuan(Department of Neonatology,Xinhuan Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Deparment of Obstetrics,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院新生儿科,200092 [2]上海交通大学医学院附属新华医院产科,200092

出　　处：《中华新生儿科杂志（中英文）》2021年第5期40-44,共5页Chinese Journal of Neonatology

基　　金：上海申康医院发展中心临床科技创新项目(SHDC12016217)。

摘　　要：目的探讨完整脐带挤勒和脐带结扎后挤勒两种方式对早产儿贫血的早期影响。方法选取2019年1~10月上海交通大学医学院附属新华医院剖宫产出生的胎龄<34周早产儿进行前瞻性研究,随机分为完整脐带挤勒组和脐带结扎后挤勒组。对比两组早产儿出生后不同时间血红蛋白、红细胞压积、血清铁水平、生后7 d内贫血率、输血率、经皮胆红素水平及光疗时间等。应用SPSS 22.0统计软件进行数据分析。结果共纳入完整脐带挤勒组30例,脐带结扎后挤勒组30例。完整脐带挤勒组入院时、生后7 d、生后14 d血红蛋白水平、红细胞压积、血清铁水平均高于脐带结扎后挤勒组,差异有统计学意义(P<0.05)。完整脐带挤勒组生后7 d贫血率[3.3%(1/30)比33.3%(10/30)]和输血率均低于脐带结扎后挤勒组[13.3%(4/30)比56.7%(17/30)],差异有统计学意义(P<0.05)。两组早产儿经皮胆红素、光疗总时长及住院期间并发症发生率差异均无统计学意义(P>0.05),均未发生红细胞增多症。结论完整脐带挤勒较脐带结扎后挤勒能更有效提高早产儿生后早期体内血红蛋白水平和铁储备,降低了早产儿输血需求及贫血发生率,是预防和减轻早产儿贫血的有效干预措施。Objective To study the early effects of intact-umbilical cord milking(I-UCM)and cut-umbilical cord milking(C-UCM)for the prevention of anemia of prematurity in preterm infants.Method From January 2019 to October 2019,C-section delivered infants with gestational age<34 weeks were randomly assigned into I-UCM group and C-UCM group.Hematological parameters at different timepoints after birth,iron status,incidence of anemia within 7 d after birth,blood transfusions,transcutaneous bilirubin levels and the total duration of phototherapy were collected and analyzed.Result A total of 60 cases were enrolled,including 30 in I-UCM group and 30 in C-UCM group.I-UCM group had significant higher levels of hemoglobin(Hb),hematocrit(Hct)and serum iron on admission(P<0.05).Comparing with C-UCM group,Hb and Hct were significantly higher in I-UCM group at 7 d and 14 d after birth(P<0.05).Lower prevalence of anemia within 1 week[3.3%(1/30)vs.33.3%(10/30),P<0.05]and less blood transfusions during hospitalization[13.3%(4/30)vs.56.7%(17/30)]were noted in I-UCM group.No statistically significant differences existed between the two groups in phototherapy duration and the peak bilirubin levels(P>0.05).Conclusion I-UCM can provide more placental transfusion at birth to increase Hb levels and iron storage to prevent and reduce anemia in preterm infants.

关 键 词：贫血 婴儿 早产 脐带挤勒 完整脐带挤勒 断脐后脐带挤勒 

分 类 号：R722.6[医药卫生—儿科]