不同脐带结扎时间对早产儿及产妇的影响  

Effects of Different Umbilical Cord Ligation Times on Preterm Infants and Mothers

作　　者：郭志峰[1] 林志青[1] 陈水利 杨芳琳 魏晓帆 冯骁 GUO Zhifeng;LIN Zhiqing;CHEN Shuili;YANG Fanglin;WEI Xiaofan;FENG Xiao(Department of Pediatrics,Zhongshan Hospital,Xiamen University,Xiamen,Fujian Province,361000 China)

机构地区：[1]厦门大学附属中山医院儿科,福建厦门361000

出　　处：《中外医疗》2023年第5期7-12,共6页China & Foreign Medical Treatment

摘　　要：目的 通过检测不同脐带结扎时间早产儿及产妇各项指标的情况,探讨不同脐带结扎时间对早产儿及产妇妊娠结局的影响。方法 方便选取2018年4月—2021年5月在厦门大学附属中山医院产科妊娠28~37周阴道分娩的早产儿320例,根据结扎脐带时间分为A组(立即脐带结扎)、B组(胎儿娩出后60 s延迟脐带结扎)、C组(胎儿娩出后120 s延迟脐带结扎)、D组(胎儿娩出后180 s延迟脐带结扎),各80例。分别检测新生儿生后24 h血红蛋白(Hb)水平、红细胞压积(HCT)、出生5 d内血清胆红素的变化及光疗率、新生儿早期体温的情况及低血糖的发生率,统计新生儿坏死性小肠结肠炎、脑室周围-脑室内出血、新生儿呼吸窘迫综合征的发生率及住院期间输血率、平均机械通气时长和产妇产后出血发生率及分娩前后血红蛋白水平的变化。结果 出生后24 h,B、C、D组Hb水平(169.32±15.23)、(173.44±18.27)、(178.79±17.29)g/L和HCT水平(52.97±5.21)%、(55.57±4.89)%、(58.48±5.88)%均高于A组(152.38±14.33)g/L、(46.32±4.97)%,差异有统计学意义(P<0.05)。出生后第3、5天,B、C、D组新生儿血清总胆红素水平均高于A组,差异有统计学意义(P<0.05)。B组、C组、D组低血糖的发生率均小于A组,差异有统计学意义(P<0.05)。B、C、D组患儿脑室周围-脑室内出血的发生率(7.50%、8.75%、10.00%)及住院期间输血率(21.2%、17.5%、20.0%)均低于A组的(21.3%、37.5%),差异有统计学意义(P<0.05)。结论 早产儿60~180 s的延迟脐带结扎在降低脑室周围-脑室内出血、新生儿低体温、新生儿低血糖的发生率及降低早产儿输血率方面效果一致,且不影响早产儿光疗率及产妇分娩出血量。Objective To investigate the effects of different cord ligation times on pregnancy outcomes of preterm infants and mothers by testing various indicators of preterm infants and mothers at different cord ligation times.Methods 320 premature infants who were delivered vaginally at the Obstetrics and Gynecology Department of Zhongshan Hospital Affiliated to Xiamen University from April 2018 to May 2021 were conveniently selected.They were divided into group A(immediate umbilical cord ligation),group B(delayed umbilical cord ligation 60 seconds after fetal delivery),group C(delayed umbilical cord ligation 120 seconds after fetal delivery),and group D(delayed umbilical cord ligation 180 seconds after fetal delivery)based on the time of umbilical cord ligation,with 80 cases in each group.Detected the levels of hemoglobin(Hb),hematocrit(HCT)at 24 hours after birth,within 5 days of birth changes in serum bilirubin phototherapy rate,early neonatal body temperature,and incidence of hypoglycemia in newborns.Calculated the incidence of neonatal necrotizing enterocolitis,periventricular intraventricular hemorrhage,neonatal respiratory distress syndrome,blood transfusion rate during hospitalization,and the average duration of mechanical ventilation and the incidence of postpartum hemorrhage in postpartum women,changes in hemoglobin levels before and after delivery.Results 24 hours after birth,the Hb levels(169.32±15.23)g/L,(173.44±18.27)g/L,(178.79±17.29)g/L,and HCT levels(52.97±5.21)%,(55.57±4.89)%,and(58.48±5.88)%in group B,group C,and group D were all higher than those in group A(152.38±14.33)g/L and(46.32±4.97)%,the difference was statistically significant(P<0.05).On the 3rd and 5th day after birth,the serum total bilirubin levels of newborns in group B,group C,and group D were all higher than those in group A,the difference was statistically significant(P<0.05).The incidence of hypoglycemia in group B,group C,and group D was lower than that in group A,and the difference was statistically significant(P<0.05).The inc

关 键 词：延迟脐带结扎 早产儿 阴道分娩 结扎时机 

分 类 号：R4[医药卫生—临床医学]