不同断脐时间对早产儿血红蛋白及胆红素的影响

目的 探讨不同断脐时间对早产儿血红蛋白及胆红素的影响,为改善早产儿贫血和黄疸提供临床依据。 方法 选择2013年12月-2014年12月在丽水市人民医院分娩的早产儿70例为研究对象。随机将70例早产儿分为晚断脐组和早断脐组各35例。早断脐组胎儿娩出后10 s内断脐,晚断脐组出生2 min后,或等待脐带搏动停止后断脐。对比2组早产儿经皮胆红素值和高胆红素血症发生率,以及血红蛋白水平(hemoglobin,Hb)和红细胞压积(hematokrit,HCT)。 结果 晚断脐组早产儿Hb、HCT在出生和出生后3 d分别为(168.25±13.73) g/L、(184.52±15.95) g/L、(0.51±0.04)%、(0.57±0.05)%,显著高于早断脐组(157.65±16.82) g/L、(165.04±17.31) g/L、(0.46±0.04)%、(0.50±0.04)%,差异均有统计学意义(P<0.05)。早断脐组和晚断脐组早产儿经皮胆红素测量值以及高胆红素血症发生率,差异无统计学意义(P>0.05)。 结论 晚断脐法不但可以提高早产儿的血容量和血红蛋白含量,有助于预防早产儿贫血,还不会增加高胆红素血症的发生率,值得临床进一步探讨和推广。 

Effects of different clamping time of umbilical cord on serum bilirubin and hemoglobin in premature infant

Objective To investigate the effects of different clamping time of umbilical cord on serum bilirubin and hemoglobin in premature infant. Methods A Total of 70 cases of premature infants in our hospital from December,2013 to December,2014 were randomly divided into two groups with 35 cases in each group.Late umbilical group was given late umbilical after pulsation arrest,and early umbilical group was given early clamping in 10s after birth.Percutaneous bilirubin values and high blood bilirubin rate,hemoglobin levels and hematokrit of two groups were recorded and compared. Results Hb and HCT of premature infants in late umbilical group at birth and after 3 d of birth were (168.25±13.73) g/L,(184.52±15.95) g/L,(0.51±0.04)%,(0.57±0.05)% respectively,while in the early umbilical group were (157.65±16.82) g/L,(165.04±17.31) g/L,(0.46±0.04)%,(0.50±0.04)%,with statistically significant difference (P<0.05).Percutaneous bilirubin values and high blood bilirubin rate showed no significant difference in two groups (P>0.05). Conclusion The late umbilical method can not only improve the blood volume of preterm infants and hemoglobin content,prevent premature anemia,also would not increase the incidence of high blood bilirubin,worthy of further clinical discussion and promotion.