延迟脐带结扎用于剖宫产极早早产儿复苏的效果  

Efficacy of delayed cord clamping in resuscitation of very preterm infants undergoing Cesarean section

作　　者：金丹[1] 万丽[1] JIN Dan;WAN Li(Department of Surgical Anesthesia,Jiaxing Maternity and Child Health Care Hospital,Jiaxing 314001,CHINA)

机构地区：[1]嘉兴市妇幼保健院手术麻醉科,浙江314001

出　　处：《江苏医药》2022年第6期598-602,共5页Jiangsu Medical Journal

摘　　要：目的观察延迟脐带结扎(DCC)用于剖宫产极早早产儿(VPI)复苏的效果。方法38例行剖宫产有活力的VPI随机均分为两组:A组VPI娩出后DCC;B组VPI娩出后立即剪断脐带。比较两组VPI的相关指标:窒息情况、呼吸机辅助通气应用情况、Apgar评分、出生后1 h的血气分析、血糖和无创血红蛋白,记录并发症发生情况。结果两组VPI窒息发生、应用呼吸机辅助通气的比例和辅助通气时间无统计学差异(P>0.05)。A组1-min Apgar评分低于B组(P<0.01)。出生后1 h,A组无创血红蛋白高于B组(P<0.05)。A组出现贫血、脑室内出血/颅内出血的比例少于B组,出现黄疸、胆汁淤积的比例多于B组(P<0.05)。结论剖宫产VPI娩出后DCC可降低新生儿贫血、脑室内出血/颅内出血的发生率,提升VPI存活率和生存质量,但可能会增加黄疸的发生率。Objective To observe the efficacy of delayed cord clamping(DCC)in the resuscitation of the very preterm infants(VPI)undergoing Cesarean section.Methods Thirty-eight viable VPI undergoing Cesarean section were resuscitated with DCC(group A,19 cases)or after cutting the umbilical cord(group B,19 cases).The incidence rates of asphyxia and use of ventilator-assisted ventilation were compared between the two groups.The Apgar score after birth was evaluated,blood gas analysis,blood glucose and noninvasive hemoglobin 1 hour after birth were detected.The incidence of neonatal complications was observed.Results The proportions of the VPI with asphyxia and use of ventilator-assisted ventilation were not significantly different between the two groups(P>0.05).The 1-minute Apgar score was lower and noninvasive hemoglobin 1 hour after birth was higher in group A than those in group B(P<0.05).The proportions of the VPI with anemia and intraventricular hemorrhage/intracranial hemorrhage in group A were less than those in group B(P<0.05).The proportions of the VPI with jaundice and cholestasis were more in group A than those in group B(P<0.05).Conclusion DCC in the resuscitation of VPI undergoing Cesarean section can reduce the incidence of neonatal anemia and intraventricular hemorrhage/intracranial hemorrhage,and improve the survival rate and life quality of VPI,but may increase the incidence of VPI jaundice.

关 键 词：延迟脐带结扎 剖宫产 早产儿复苏 

分 类 号：R722[医药卫生—儿科]