延迟钳夹脐带对早产儿早期血容量影响的临床研究

目的 探讨延迟钳夹脐带对早产儿早期血容量的影响.方法 将2007年10月至2010年6月在东莞市石龙博爱医院产科经阴道分娩的194例早产儿随机分为两组,即常规钳夹脐带组100例和延迟钳夹脐带组94例.比较分析两组经阴道分娩早产儿的钳夹脐带时间,生后24h、48h、72 h的Hb、RBC、红细胞压积、血压、血氧饱和度和贫血的发生率,以及生后第1天、第2天、第3天和第7天的静脉血胆红素值.结果 延迟钳夹脐带组脐带钳夹时间为(100.14±10.57)s,常规钳夹脐带组脐带钳夹时间为(22.40±5.02)s,两组脐带钳夹时间比较差异有统计学意义(P＜0.005).延迟钳夹脐带组早产儿生后前3 d的Hb及血压均比常规钳夹脐带组高,两组比较差异有统计学意义(P＜0.05).延迟钳夹脐带组94例早产儿中,3 d内发生贫血3例,发生率为3.19%,常规钳夹脐带组100例早产儿中,3 d内发生贫血11例,发生率为11.00%,延迟钳夹脐带组贫血发生率低于常规钳夹脐带组(P＜0.05).两组早产儿出生后7 d内的静脉血胆红素值比较无明显差异(P＞0.05).结论 延迟钳夹脐带对早产儿Hb及血压有明显影响,可提高阴道分娩早产儿早期血容量,减少早产儿早期贫血的发生.

Early effects of delayed ligature of the umbilical cord on the blood volume in premature infants

Objective To evaluate the effect of delayed ligature of the umbilical cord on the blood volume in premature infants in early time. Methods From Oct 2007 to Jun 2010,194 premature infants with vaginal birth in department of genecology and obstetrics were randomly divided into routine ligature of the umbilical cord group (100 cases) and delayed ligature of the umbilical cord group (94 cases), comparision were made on ligature time, blood routine examination,blood pressure,oxyhemoglobin saturation and anemia incidence in 24 h,48 h,and 72 h after birth,and hemobilirubin on 1 d,2 d,3 d,and 7 d after birth. Results There were significant differences between the two groups in delayed ligature time [(100. 14 + 10. 57) s vs (22. 40 +5.02) s,P ＜0. 05)]. The hemoglobin and blood pressure in delayed ligature umbilical group were increased significantly(P ＜ 0. 05). There was 3 cases (3. 19%) of anemia in delayed ligature of the umbilical cord group, and 11 cases (11.00%) in routine ligature of the umbilical cord group, which showed significant difference (P ＜ 0. 05). And the hemobilirubin on 7 d after birth showed no significant difference between the two groups(P ＞ 0. 05). Conclusion Delayed ligature of umbilical cord has a significant influence on hemoglobin and blood pressure of premature infant. It can increase the blood volume, and reduce the incidence of anemia in early time.