气门芯脐带根部结扎法的临床效果观察

目的应用气门芯脐带根部结扎,缩短脐带脱落时间,促进脐部尽早愈合,减少新生儿脐部并发症的发生。方法将我科2011年1月～5月足月自然分娩和剖宫产分娩的新生儿826例,按出生时间的顺序进行编号分为实验组和对照组,各413例。实验组采用气门芯脐带根部结扎。对照组采用传统结扎法。观察两组脐带脱落时间和并发症发生率。结果实验组脐带脱落时间短于对照组(P<0.01),脐部并发症除脐部感染外发生率低于对照组(P<0.01)。结论气门芯脐带根部结扎,可缩短脐带脱落时间,减少脐部并发症发生率和促进脐部尽早愈合,适合产科临床应用。     

脐带夹和气门芯双重结扎并离断新生儿脐带的效果

目的 探讨脐带夹和气门芯双重结扎并离断新生儿脐带的临床效果.方法 将210名新生儿随机分为3组,每组各70例,分别采用气门芯、脐带夹、脐带夹和气门芯双重法结扎并离断脐带.结果 脐带夹和气门芯双重结扎并离断脐带组脐带残端渗血、分泌物增多和脐周红肿的发生率均低于其余两组(均P<0.05),脐带夹组残端渗血的发生率最高(34...     

特殊脐带夹和气门芯用于脐带结扎的效果比较

目的比较特殊脐带夹和气门芯用于新生儿脐带结扎的效果。方法新生儿173例,按产妇意愿分为A组(气门芯组)和B组(特殊脐带夹组),比较两组新生儿脐带结扎效果,包括结扎脐带时溅血、第2次定位发生率、脐带残端渗血、脐周皮肤发红及破损、脐带脱落时间。结果 B组结扎脐带时溅血、第2次定位发生率、脐带残端渗血少于A组,两组脐带脱落时间、脐周皮肤发红及破损发生无明显差异。结论新生儿脐带结扎应用特殊脐带夹的效果优于气门芯。     

气门芯结扎脐带人工剪除法的临床应用

气门芯结扎脐带人工剪除法的临床应用孙帮琴，鲁平，吴纯玉，陈荣娟，梁欣，胡爱珍，李明英关键词结扎脐带，气门芯，剪除Ｋｅｙｗｏｒｄｓ：ＬｉｇａｔｉｏｎｏｆｕｍｂｉｌｉｃａｌｃｏｒｄＶａｌｖｅｏｆｒｕｂｂｅｒｔｕｂｅＥｘｔｅｒｍｉｎａｔｅ目前，处理脐带的方...     

两种新生儿脐带结扎方法的效果观察

目的观察两种新生儿脐带结扎方法的效果,以选择适合基层医院处理脐带的方法。方法将360例新生儿,按产妇意愿分成A组(特殊脐带夹组)和B组(气门芯组),各180例,比较两组新生儿脐带自然脱落时间、脐带残端出血发生率、脐部感染发生率、脐周皮肤破损情况,评价两种脐带结扎方法中材料成本。结果脐带自然脱落时间A组(10.5±3.6)d,B组(7.2±2.5)d,两组比较,P0.05;脐周皮肤破损发生率A组2.78%、B组0,两组比较,P0.05;两组脐带残端出血率和脐部感染发生率比较,差异无统计学意义。材料成本气门芯0.5元/枚、特殊脐带夹78元/只。结论基层医院宜用气门芯结扎新生儿脐带。     

气门芯结扎新生儿脐带的制作与应用

材料与制作 （1）取自行车上专用气门芯管剪成若干个1．0～1．5mm长的小管备用；（2）取棉线剪成20-25cm长的短线若干根备用；（3）将2个剪好的气门芯用1根棉线穿好并双折打结后备用；（4）将以上准备好的气门芯2～3个放人产科专用器械包内高压灭菌后备用。     

气门芯橡皮圈双层套扎脐带的临床观察

通过对１７６６例新生儿采用气门芯，橡皮圈双层套扎处理脐带后的临床效果观察，发现应用此方法的新生儿，其脐部并发症的发生率明显少于以往的断脐方法，两组实验结果经统计学处理差别非常显著。同时就结扎后脐残端保留的长度及二次断脐时间进行了讨论，提出脐残端保留长度以２ｃｍ为宜，二次断脐时间以４８ｈ为宜的观点。     

脐带夹和气门芯脐带结扎效果的对照研究

新生儿脐部是病原微生物入侵的门户,脐部处理不当极易发生局部感染。如果残端脱落和脐部愈合早,感染几率会逐步降低。由此可见分娩后脐部结扎及护理的重要性。目前根据结扎用具不同,脐带结扎方法可分为线、气门芯、脐带夹和血管钳结扎^[1]。不同研究对这几种方法结论不一。本研究观察气门芯法和脐带夹法脐带结扎效果,并随访脐带脱落时间,前瞻性比较两种脐带结扎方法的脐部护理情况。现将结果报道如下。     

早产儿不同时间二次剪脐效果的临床观察

[目的]分析172例早产儿不同时间二次剪脐的临床效果,探讨最佳的二次剪脐时间。[方法]对住院的早产儿按二次剪脐时间的不同分为3组：A 组二次剪脐时间为出生后48 h~71 h,B 组二次剪脐时间为出生后72 h~96 h,C 组二次剪脐时间为＆gt;96 h,观察不同时间二次剪脐发生脐部出血及脐部炎症的发生率。[结果]B组在剪脐时脐部出血以及剪脐后第2天、第3天发生脐部渗血明显低于 A 组（P〈0.05）,脐部炎症发生率明显低于 C组（P〈0.05）。[结论]早产儿脐部护理二次剪脐的最佳时间为出生后72 h~96 h。     

两种脐带残端处理方法的效果观察

目的探讨彻底清除脐带残端内的血管和华通胶的脐带残端处理方法与传统方法对脐带脱落和脐部感染的影响。方法将800例正常新生儿按出生单双日分为两组,观察组采用彻底清除脐带残端内血管和华通胶的处理方法,对照组采取传统方法,观察并比较两组新生儿脐带脱落时间及脐部感染的情况。结果两组新生儿脐部干湿情况、脐部感染的差异有统计学意义（P〈0．05或P〈0．01）,脐带脱落时间差异有统计学意义（P〈0．01）。结论彻底清除脐带残端内的血管及华通胶的处理方法,缩短了脐带脱落时间,减少了局部渗血、渗液,降低了脐部感染几率,促进脐部愈合。     

彩超评估脐带旋转指数与脐带异常附着的相关性研究

目的：观察脐带旋转指数异常与脐带附着异常是否相关。方法：超声检测350例孕晚期胎儿的脐带旋转指数（1／A）。该指数为脐动脉围绕脐静脉旋转1个周期后占脐静脉的长度的倒数,指数小于0．1考虑为少旋转。分娩后测量脐带附着点到胎盘边缘的距离,将结果分为正常附着、边缘性附着和帆状附着。结果：少旋转组的胎儿脐带约有76．5％为异常附着,正常旋转或高旋转约有2．2％的脐带异常附着,胎儿脐带旋转指数与脐带附着点到胎盘边缘距离之间的相关系数为r=0．953。结论：脐带少旋转与脐带异常附着有显著相关性,若存在脐带少旋转则可提示存在脐带异常附着。     

The expression of the NB1 antigen on myeloid precursors and neutrophils from children and umbilical cords

The neutrophil-specific antigen NB1 is expressed by neutrophils from 97% of healthy adults. However, membrane expression of this molecule is unique in that it is found on only a subpopulation of neutrophils present in NB1-positive adults. We have investigated the ontogeny of NB1 antigen expression by haematopoietic progenitor cells to determine the stage and pattern of antigen expression during granulocytic cell differentiation. In addition, we examined whether the ontogeny and frequency of granulocytic cells expressing the NBl antigen might vary in subjects according to age. A monoclonal antibody (MoAb) specific for NB1 (1B5) and flow cytometry was used to assess the frequency and characteristics of the NB1-positive cells found in umbilical cord blood (n = 11), children (n = 37), healthy adults (n = 46) and patients with chronic myelogenous leukaemia (n = 8). We also used flow cytometry to isolate NB1-positive and NB1-negative bone marrow and peripheral blood cells from various tissue sources. The separated subpopulations were then analysed by Wright stain and light microscopy. The size of the NB1-positive neutrophil subpopulation in 46 healthy adults (56 ± 19%) was identical to that found for neutrophils from 36 children ranging in age from 8 months to 18 years (56 ± 11%). In contrast, expression of the NB1 antigen by the neutrophils present in umbilical cord blood (91 ± 3%, n = 11) was significantly greater than that in adults (P < 0.002) or children (P < 0.002). We also examined the size of the NB1-positive subpopulation among neutrophils from eight patients with chronic myelogenous leukaemia (CML). The NB1-positive subset in CML subjects (29.5 ± 22.4%) was significantly less that in healthy adults (P < 0.02) or children (P < 0.02). Marrow cells from eight adults were similarly separated and analysed. We found that 69 ± 17% of segmented and band forms of neutrophils, 70 ± 2% of metamyelocytes and 61 ± 23% of myelocytes were NB1-positive. In fetal bone marrow, 86 ± 9% of the segmented and band forms, 82 ± 10% of the metamyelocytes and 3 ± 4% of myelocytes were NB1-positive. In conclusion, neutrophil-specific antigen NB1 is first expressed at the myelocyte stage of myeloid differentitation. In adult bone marrow, the percentages of myelocytes, metamyelocytes and segmented or band cells that expressed this antigen were similar and comparable in magnitude to the frequency of NB1-positive neutrophils found in the circulation. Although the size of the NBl-positive neutrophil subpopulation was the same in healthy adults and children, it was significantly increased in umbilical cord blood, and in fetal marrow cells.     

脐带间充质干细胞在不同培养体系条件下的生物学特性

背景：体外培养的脐带间充质干细胞在不同培养体系下生长状态差异显著,因此选取一种更适合的培养基相当必要。目的：对比观察人脐带间充质干细胞在3种培养基中的生长增殖情况,并检测细胞免疫表型以及间充质干细胞的诱导分化能力。方法：在无菌条件下用贴块法收获人脐带间充质干细胞,用T75培养瓶培养传代后,取第3代脐带间充质干细胞分别种入到含体积分数为5%胎牛血清的DMEM/F12培养基、含体积分数为10%胎牛血清的DMEM/F12培养基和Mesen PRO RSTM培养基中,培养第1,3,5,7天进行细胞计数,绘制细胞生长曲线。采用流式细胞仪分析第3代脐带间充质干细胞免疫表型,并检测其成骨及成脂肪诱导分化能力。结果与结论：培养出的第3代人脐带间充质干细胞高表达CD44、CD73、CD90、CD105,不表达CD29、CD31、CD34、HLA-DR。经成脂诱导后,油红O染色可见胞浆中有大量红色小脂滴;成骨诱导后,茜素红染色后镜下可见成骨样细胞团,说明脐带间充质干细胞在体外具有多向分化的潜能。在倒置显微镜下观察可见含体积分数为10%胎牛血清的DMEM/F12培养基中的细胞集落密集,形态均匀,而其他2种培养基中的细胞集落密集程度和形态都不如前者好。在培养传代细胞时,可优先选择含体积分数为10%胎牛血清的DMEM/F12培养基。     

二次剪脐对新生儿脐部护理效果的影响

目的探讨二次剪脐在新生儿脐部护理中的应用效果。方法将400例新生儿随机分为对照组和实验组,每组各200例。对照组新生儿采用传统的气门芯摘脐护理方法,等待残端自然脱落;实验组在气门芯摘脐的基础上,于新生儿出生后48h,在结扎下方用手术剪刀剪去残端脐带。比较两组新生儿脐部并发症的发生率。结果实验组新生儿脐部并发症发生率低于对照组(P0.01)。结论二次剪脐是提高新生儿脐部护理质量、预防并发症的有效措施。     

Sonographic umbilical vessel morphometry and perinatal outcome of fetuses with a lean umbilical cord

PURPOSE: This study was undertaken to assess whether changes in umbilical cord vessel morphometry are associated with an increased risk of adverse perinatal outcome among fetuses with a lean umbilical cord on sonography. PATIENTS AND METHODS: A total of 160 fetuses with a sonographically lean umbilical cord (cross-sectional area below the 10th percentile for gestational age) after 20 weeks of gestation were enrolled. The cross-sectional areas of the umbilical cord and its vessels were measured. Outcome variables investigated were perinatal death, admission to the neonatal intensive care unit, intrauterine growth restriction, and 5-minute Apgar score. RESULTS: The proportions of perinatal death (1/96 versus 6/64, p < 0.05) and admission to the neonatal intensive care unit (17/96 versus 22/64, p < 0.05) was significantly higher among fetuses with an umbilical vein area below or equal to the 10th percentile for gestational age than among those with an umbilical vein area greater than the 10th percentile. No differences were found in the proportions of perinatal death, neonatal intensive care unit admission, 5-minute Apgar score < 7, and intrauterine growth restriction when fetuses with umbilical vein areas below or equal to the 10th, the 5th, and the 2.5th percentiles for gestational age were compared. No difference was found in the umbilical artery area and Wharton's jelly area among the groups. CONCLUSION: Among fetuses with a sonographically lean umbilical cord, a significant relationship exists between an umbilical vein area below or equal to the 10th percentile and an adverse neonatal outcome.     

人脐血单个核细胞和脐带间充质干细胞移植用于大鼠脊髓损伤的实验研究

目的:探讨人脐血单个核细胞和脐带间充质干细胞(MSCs)移植对脊髓损伤功能恢复的影响,寻找一种更适合治疗脊髓损伤的细胞源。方法:采集新鲜人脐带血和脐带,分离培养单个核细胞和MSCs。将脊髓损伤模型随机分成3组:单个核细胞移植组、MSCs移植组和低糖必需培养基(L-DMEM)培养组。采用免疫组化和免疫荧光检测细胞移植后1—4周细胞在脊髓内的存活情况和迁移情况,使用BBB行为学评分评估大鼠脊髓功能恢复情况。结果:L-DMEM培养液组在术后各时间点观察评分无明显差异,而细胞移植组脊髓功能处于逐渐恢复过程,与L-DMEM培养液比较,差异有显著性意义。单个核细胞移植组对损伤脊髓功能的修复作用较MSCs移植组显著,且差异有显著性意义。结论:与MSCs相比较,人脐血单个核细胞更适合作为治疗脊髓损伤的细胞源。     

新生儿脐带结扎方法的研究进展

描述新生儿脐带结扎的历史进展,总结棉线结扎、脐带夹结扎与气门芯结扎的优缺点。     

不同培养体系培养人脐血源基质细胞的探索性研究

目的 探索不同培养体系对人脐血源基质细胞原代培养的影响，并观察人脐血源基质细胞的生物学特性。方法 取产科胎儿脐带血，采用经典和改良Dexter培养体系培养人脐血源基质细胞。倒置显微镜动态观察细胞生长情况，瑞氏染色观察细胞形态特征，采用细胞化学和免疫细胞化学进行鉴定。结果 改良Dexter培养体系在48 h细胞贴壁数、细胞开始伸展时间及原代培养时间明显优于经典Dexter培养体系。原代培养9-14天(平均12.1天)时贴壁细胞集落开始形成，15-21天(平均19.4天)时集落数量最多，培养28天贴壁细胞铺满培养皿底，细胞类型以成纤维样细胞、巨噬样细胞、“小圆”类细胞为主。细胞化学染色显示：非特异性酯酶染色法(NSE)显示阳性，阳性率100％；过氧化物酶染色法(POX)显示阴性；糖原染色(PAS)显示阳性，阳性率为100％；碱性磷酸酶(ALP)染色显示部分阳性，阳性率26％。免疫细胞化学染色显示：CD31显示阳性率为96％，CD68显示阳性率为95％，CD45阴性，Fn显示阳性率94％。结论 改良Dexter培养体系是一种理想人脐血源基质细胞培养体系，人脐血源基质细胞在体外的成功培养为从一新的角度进一步研究其在临床的早日应用提供理论基础。