延迟断脐对新生儿生理意义的研究现状

20世纪后,新生儿出生时立即结扎脐带为产科临床上的常规操作。但是,国内外大量研究结果表明,延迟断脐(DCC)可改善新生儿营养状况与健康结局,而且该项技术受到包括世界卫生组织(WHO)在内的多个国际专业机构及组织推荐。目前研究结果表明,DCC有益于新生儿,具有可以增加新生儿血容量、降低其贫血发生率及减少缺血缺氧性脑损伤等并发症发生率等优势。但是,对于DCC的最佳时机及其潜在益处、风险等问题,目前则尚未达成共识。关于DCC对新生儿生理意义的研究,不但可明确DCC的生理机制,还可更新医护人员对断脐时间的传统固有观念,对DCC的临床应用及推广具有积极作用。笔者拟就DCC时间选择、DCC与胎盘输血、DCC与新生儿呼吸功能及DCC对新生儿影响的最新研究现状进行阐述。

Physiological mechanisms of delayed umbilical cord clamping on neonates: research status

After the 20^th century, early cord clamping become a routine operation in obstetrics domain. In recent years, however, a large number of studies have shown that delayed cord clamping (DCC) can improve the nutritional status and health outcomes of neonates, and DCC has been recommended by many internationally professional institutions and organizations including World Health Organization (WHO). Current researches indicate that DCC is extremely beneficial to neonates. For example, DCC can increase the blood volume of neonates, reduce the incidence of anemia, and reduce the incidence of complications, such as hypoxic-ischemia brain damage. However, there is no consensus on the optimal timing and other potential benefits and risks of DCC. Studies on the physiological significance of DCC to the neonates can not only confirm the physiological mechanisms of DCC, but also update the traditional concepts of health care staff about the timing of umbilical cord clamping, which contributes to the universal implementation and application of DCC. This article focuses on recent research status of the timing of DCC, DCC and placental transfusion, DCC and respiration functions of newborns, influences on newborns of DCC etc..