延迟脐带结扎对中晚期早产儿结局的影响

目的 分析延迟脐带结扎(DCC)对中晚期早产儿结局的影响,以期为改善中晚期早产儿结局提供参考。方法 选择2016年1月-2017年1月在淮坊医学院附属医院出生的中晚期早产儿共116例,随机分为延迟脐带结扎(DCC)组(n=55)与早脐带结扎(ECC)组(n=61),比较两组早产儿1 min及5 min Apgar评分,生后12 h、1周、4周血红蛋白(Hb)及红细胞压积(HCT),胆红素峰值,达峰时间,以及贫血、输血、红细胞增多症、颅内出血、败血症、新生儿呼吸窘迫综合征(RDS)的情况。结果 延迟脐带结扎组生后12 h、1周、4周血红蛋白、红细胞压积均高于早脐带结扎组,差异有统计学意义(P均<0.05)。延迟脐带结扎组4周内贫血发生率及住院期间输血率均低于早脐带结扎组,差异有统计学意义(P均<0.05)。两组早产儿1 min及5 min Apgar评分、胆红素峰值、达峰时间,以及住院期间红细胞增多症、颅内出血、败血症、RDS的发生率相比较,差异无统计学意义(P均>0.05)。结论 延迟脐带结扎可提升中晚期早产儿血红蛋白及红细胞压积水平,降低其贫血发生率及住院期间输血概率,不增加其他相关并发症的发生率,能改善中晚期早产儿结局。

Influence of delayed cord clamping on the outcome of moderate and late preterm infants

Objective To investigate the influence of delayed cord clamping (DCC) on the outcome of moderate and late preterm infants(MPIs), in order to provide reference for improring the outcome of MPIs. Methods Totally 116 cases of moderate and late preterm infants delivered in the Affiliated Hospital of Weifang Medical University from January 2016 to January 2017 were randomly divided into delayed cord clamping(DCC)group (n=55) and early cord clamping (ECC) group (n=61).The Apgar score of 1 min and 5 min, the level of hemoglobin (Hb) and hematocrit(HCT) in 12 hours,1 week and 4 weeks after birth, bilirubin peak, the time for bilirubin arriving peak, and the incidence rates of anemia, blood transfusion, erythrocytosis, intracranial hemorrhage, sepsis and respiratory distress syndrome (RDS) were compared between DCC group and ECC group. Results The levels of hemoglobin and hematocrit in 12 hours,1 week and 4 weeks after birth in DCC group were significantly higher than those in ECC group (all P<0.05).The incidence rates of anemia in 4 weeks after birth and blood transfusion during hospitalization in DCC group were also significantly lower than those in ECC group (all P<0.05).However, there were no significant differences on the Apgar score of 1 min and 5 min, bilirubin peak, the time for bilirubin arriving peak, and the incidence rates of erythrocytosis, intracranial hemorrhage, sepsis, RDS between DCC group and ECC group (P>0.05). Conclusions Delayed cord clamping can increase hemoglobin and hematocrit levels in moderate and late preterm infants, reduce the incidence of anemia and blood transfusion. Meantime, delayed cord clamping do not increase the incidence of complications, so it can be used to improve the outcome of moderately and late preterm infants.