不同断脐时间对阴道分娩早产儿的影响

摘要

目的:探讨不同断脐时间对阴道分娩早产儿的影响.方法 :选择120例经阴道分娩的早产儿及产妇作为研究对象.将120例产妇按照随机数字表法分为A、B、C、D组,各30例.A组:产后10 s内立即断脐;B组:产后30 s断脐;C组:产后60 s断脐;D组:产后90 s断脐.收集各组产妇、新生儿基本资料,记录各组新生儿血红蛋白(Hb)和红细胞压积(HCT)值、贫血发生率、输血率、经皮胆红素高峰值、光疗时间、高胆红素血症发生率、颅内出血发生率.结果 :B、C、D组早产儿生后24 h Hb和HCT值均高于A组(P0.05).B、C、D组早产儿出生后1周Hb和HCT值均高于A组(P0.05).B、C、D组早产儿贫血率、输血率均低于A组(P0.05).4组早产儿之间经皮胆红素高峰值、光疗时间、高胆红素血症发生率、颅内出血发生率差异均无统计学意义(P>0.05).结论 :对经阴道分娩的早产儿延迟断脐30~90 s,可以改善新生儿血供,降低贫血发生率和输血率,且并不增加胆红素升高风险和光疗的风险.如果条件允许,延迟结扎脐带90 s能更好地改善早产儿预后.%Objective:To investigate the effects of different time of clamping umbilical cord on premature infant with vaginal delivery. Methods:One hundred and twenty premature infants with vaginal delivery and puerperas were investigated. One hundred and twenty puerperas were randomly divided into group A,B,C and D according to the random number table method(30 cases each group). The umbilical cord in group A,B,C and D were clamped after 0,30,60 and 90 seconds of delivery,respectively. The basic data of newborns and puerperas were collected,and the hemoglobin( Hb) level of newborn,red blood cells deposited( HCT) value,incidence of anemia, blood transfusion rate,transcutaneous bilirubin peak value,phototherapy time,incidence of high bilirubin hematic disease and incidence of intracerebral haemorrhage were recorded in all groups. Results:The 24 h Hb level and HCT value in group B,C and D were higher than those in group A(P0. 05). The Hb level and HCT value in newborns of group B,C and D after 1 week of birth were higher than those in group A(P0. 05). The incidence rates of anemia and blood transfusion in premature infants of group B,C and D were lower than those in group A(P0. 05). The differences of the transcutaneous bilirubin peak value,phototherapy time,incidence of high bilirubin hematic disease and incidence of intracerebral haemorrhage between four groups were not statistically significant(P>0. 05). Conclusions:The clamping umbilical cord of premature infant with vaginal delivery after 30 to 90 seconds of delivery can improve the neonatal blood supply,reduce the incidence of anemia and blood transfusion rate,and do not increase the risk of bilirubin increasing and phototherapy. The clamping umbilical cord of premature infants after 90 seconds of delivery can effectively improve their prognosis.