晚断脐对早产儿结局的影响(1)
[摘要] 目的 探析晚断脐对早产儿结局的影响。 方法 选择2013年3月～2014年9月本院妇产科94例早产儿作为研究对象，分为两组。对照组采取常规断脐法，观察组实行晚断脐，比较两组早产儿娩出1、5 min时Apgar评分、出生24 h后血红蛋白水平及合并症发生率。 结果 两组娩出后1、5 min时Apgar评分比较，差异无统计学意义(P>0.05)；观察组早产儿出生24 h后毛细血管血红蛋白水平为(181.9±15.6)g/L，显著高于对照组，差异有统计学意义(P<0.05)；观察组早产儿出现1例颅内出血、1例新生儿窒息、1例呼吸窘迫综合征、1例高胆红素血症、2例缺氧缺血性脑病，发生率为12.8%(6/47)，显著低于对照组29.8%(14/47)，差异有统计学意义(χ2=4.065，P=0.044)。 结论 与早断脐相比，早产儿采取晚断脐可获得更多血供及铁储备，进而增强早产儿心肺系统顺应性及机体免疫力，减少各种合并症，改善早产儿结局，具有较大的临床参考价值。
[关键词] 晚断脐；早断脐；早产儿；结局
[中图分类号] R722.6 [文献标识码] A [文章编号] 1674-4721(2015)05(b)-0092-03
Effect of Late off umbilical on premature infant
WANG Bo1 WANG Lang2 HE Ying-ying1
1.Delivery Room，Maternal and Child Health Hospital in Baoan District of Shenzhen City，Shenzhen 518133，China；2.Department of obstetrics，People′s Hospital of Huadu District in Guangzhou City，Guangzhou 510800，China
[Abstract] Objective To probe into the effect of late off umbilical on premature infant. Methods 94 cases of premature infants in the department obstetrics of our hospital from March 2013 to September 2014 were selected，and were divided into two groups.Control group was adopted to conventional umbilical method，observation group was adopted to late umbilical.Apgar score of 1 min and 5 min，birth 24 h hemoglobin level and complications between two groups was compared respectively. Results Apgar score of 1 min， 5 min after delivery of two groups had no significant difference(P>0.05)；Capillary hemoglobin levels of preterm infants born after 24 h in observation group was(181.9±15.6) g/L，was significantly higher than that in control group，with significant difference(P<0.05)，1 cases of intracranial hemorrhage，1 cases of neonatal asphyxia and 1 cases of respiratory distress syndrome，1 cases of hyperbilirubinemia and 2 cases of hypoxic ischemic encephalopathy，the incidence rate was 12.8%(6/47)，was significant lower than 29.8%(14/47) in control group，with significant difference(χ2=4.065，P=0.044). Conclusion Comparing with early umbilical，premature to take the late off umbilical can get more blood supply and iron reserves，thus enhancing the body immunity and conform to cardiovascular system and reduce various complications， improve neonatal outcomes，with great clinical reference value.
[Key words] Late off umbilical；Early off umbilical；Premature infant；Outcome
临床调查研究显示，产妇分娩后立即或在10 s内剪断脐带(称为早断脐)会对新生儿血供情况造成明显影响，导致血供量减少60～100 ml，引发血容量不足等症状，最终可能导致贫血或呼吸问题发生[1]。有循证医学研究提出，于健康新生儿脐带搏动停止后进行断脐(即晚断脐)利于其更好适应出生后循环自然转化这一过程[2]。对早产儿晚断脐可使脑室内出血及输血显著减少，有效降低新生儿肺部出现晚发性感染及各种并发症发生率[3-4]。本文以本院妇产科94例早产婴儿作为研究对象，探析晚断脐对早产儿结局的影响。 (王波 王浪 贺英英)
[关键词] 晚断脐；早断脐；早产儿；结局
[中图分类号] R722.6 [文献标识码] A [文章编号] 1674-4721(2015)05(b)-0092-03
Effect of Late off umbilical on premature infant
WANG Bo1 WANG Lang2 HE Ying-ying1
1.Delivery Room，Maternal and Child Health Hospital in Baoan District of Shenzhen City，Shenzhen 518133，China；2.Department of obstetrics，People′s Hospital of Huadu District in Guangzhou City，Guangzhou 510800，China
[Abstract] Objective To probe into the effect of late off umbilical on premature infant. Methods 94 cases of premature infants in the department obstetrics of our hospital from March 2013 to September 2014 were selected，and were divided into two groups.Control group was adopted to conventional umbilical method，observation group was adopted to late umbilical.Apgar score of 1 min and 5 min，birth 24 h hemoglobin level and complications between two groups was compared respectively. Results Apgar score of 1 min， 5 min after delivery of two groups had no significant difference(P>0.05)；Capillary hemoglobin levels of preterm infants born after 24 h in observation group was(181.9±15.6) g/L，was significantly higher than that in control group，with significant difference(P<0.05)，1 cases of intracranial hemorrhage，1 cases of neonatal asphyxia and 1 cases of respiratory distress syndrome，1 cases of hyperbilirubinemia and 2 cases of hypoxic ischemic encephalopathy，the incidence rate was 12.8%(6/47)，was significant lower than 29.8%(14/47) in control group，with significant difference(χ2=4.065，P=0.044). Conclusion Comparing with early umbilical，premature to take the late off umbilical can get more blood supply and iron reserves，thus enhancing the body immunity and conform to cardiovascular system and reduce various complications， improve neonatal outcomes，with great clinical reference value.
[Key words] Late off umbilical；Early off umbilical；Premature infant；Outcome
临床调查研究显示，产妇分娩后立即或在10 s内剪断脐带(称为早断脐)会对新生儿血供情况造成明显影响，导致血供量减少60～100 ml，引发血容量不足等症状，最终可能导致贫血或呼吸问题发生[1]。有循证医学研究提出，于健康新生儿脐带搏动停止后进行断脐(即晚断脐)利于其更好适应出生后循环自然转化这一过程[2]。对早产儿晚断脐可使脑室内出血及输血显著减少，有效降低新生儿肺部出现晚发性感染及各种并发症发生率[3-4]。本文以本院妇产科94例早产婴儿作为研究对象，探析晚断脐对早产儿结局的影响。 (王波 王浪 贺英英)