剖宫产中不同脐带结扎方式及对新生儿结局、血气分析和神经行为功能的影响  

Different methods of umbilical cord ligation of the neonates during cesarean section and their influences on the neonatal outcomes,blood gas analysis results,and neurobehav ioral function

作　　者：秦琴[1] 陈禹桥 梁秋月 张小勤[1] QIN Qin;CHEN Yuqiao;LIANG Qiuyue;ZHANG Xiaoqin(Banan Hospital Affiliated to Chongqing Medical University,Chongqing,401320)

机构地区：[1]重庆医科大学附属巴南医院,401320

出　　处：《中国计划生育学杂志》2023年第3期566-569,574,共5页Chinese Journal of Family Planning

基　　金：2021年重庆市巴南区社会事业与民生保障科技创新项目(2021-40)。

摘　　要：目的:探究剖宫产儿脐带结扎最佳方式及对新生儿结局、血气分析和神经行为功能的影响。方法:前瞻性研究,以2019年1月-2021年1月在本院行剖宫产产妇120例,随机分组为A、B、C3组,均完成剖宫产后,A组对新生儿脐带在60s内挤压,随后1~3min脐带结扎;B组新生儿出生后60s后进行脐带结扎,随后3min内行脐带挤压;C组新生儿出生后60s内直接脐带结扎。比较各组新生儿出生后10min心率以及氧分压、出生后4d的胆红素、神经功能。结果;新生儿出生后10min心率A组(146.69±1.77次/min)、B组(148.22±2.87次/min)、C组(158.81±1.66次/min)依次升高,氧分压A组(98.96±2.64)%、B组(96.28±2.43)%、C组(92.62±2.25)%依次降低,新生儿出生24h后红细胞计数、血红蛋白以及红细胞压积氧分压A组、B组、C组依次降低,新生儿原始反射、被动肌力、行为能力、主动肌力、一般状况以及总分A组(36.94±2.51分)、B组(34.76±2.45分)、C组(32.38±2.78分)依次降低(均P<0.05)。结论:剖宫产中采取新生儿脐带挤压后延迟结扎处理,新生儿血红蛋白、血细胞等显著改善,神经行为功能评分提高。Objective:To study the best method of umbilical cord ligation of the neonates during cesarean section,and to study its influence on the outcomes,blood gas analysis results and the neurobehavioral function of the neonates.Methods:A prospective study was conducted on 120 women who wanted cesarean section from January 2019 to January 2021.These women were randomly divided into three groups.The umbilical cord of the neonates of the women in group A was squeezed in 60s after born,and then was ligated within 1 to 3 minutes.The umbillical cord of the neonates of the women in group B was ligated within 60s after born,and then was squeezed in 3 minutes.The umbilical cord of the neonates of the women in group C was ligated within 60s.The values of heart rate and oxygen partial pressure at 10min after birth,the values of bilirubin and nerve function in the 4th day after birth of the neonates were compared among the three groups.Results:The heart rate of the neonates at 10min after birth in group A(146.69±1.77 beats/min),in group B(148.22±2.87 beats/min),and in group C(158.81±1.66 beats/min)had increased gradually.The value of oxygen partial pressure of the neonates at 10min after birth in group A(98.96±2.64%),in group B(96.28±2.43%),and in group C(92.62±2.25%)had decreased gradually.The values of RBC count,hemoglobin,and hematocrit of the neonates in 24h after birth in group A,group B,and group C had decreased gradually.The scores of primitive reflex,passive muscle strength,behavioral ability,and active muscle strength,and the general condition of the neonates in group A,group B,and group C had decreased gradually.The total score of neurobehavioral function of the neonates in group A(36.94±2.51 points),in group B(34.76±2.45 points),and in group C(32.38±2.78 points)had decreased gradually(all P<0.05).Conclusion:The squeezing neonatal umbilical cord and then delayed ligation of the neonates during cesarean section can significantly increase the values of the neonatal hemoglobin and blood cells,and can improve the neo

关 键 词：剖宫产 新生儿 脐带结扎 脐带挤压 血气指标 神经功能 

分 类 号：R719.8[医药卫生—妇产科学]