延迟脐带结扎对新生儿窒息复苏效果影响的初步探讨

Preliminary study on effect of delayed umbilical cord damping on resuscitation of neonatal asphyxia

目的探讨延迟脐带结扎对新生儿窒息复苏的临床效果，为减少新生儿窒息的发生及改善窒息新生儿的预后寻求新途径。方法将2011年1月至2011年12月所有在本院出生的足月新生儿随机分为两组，实验组延迟脐带结扎2分钟，对照组生后15秒内结扎脐带，比较两组复苏的临床效果。结果实验组窒息例数19例，对照组窒息例数21例，实验组较对照组窒息发生率低，差异无统计学意义（P〉0．05），5分钟复苏成功率为94．74％，较对照组高，差异无统计学意义（P〉0．05）；实验组与对照组肌酸激酶心肌同工酶（CK—MB）、血乳酸（LAC）比较差异无统计学意义（P〉0．05），但血气剩余碱（BE）值明显改善，差异具有统计学意义（P〈0．05）。结论对新生儿延迟脐带结扎可能能改善新生儿窒息复苏成功率及窒息新生儿的预后。

Objective To study the clinical effect of delayed umbilical cord clamping on the resuscitation of neonatal asphyxia, to improve the occurrence of neonatal asphyxia and prognosis of neonates with asphyxia. Methods All full-term neonates born in our hospital from January 2011 to December 2011 were randomly assigned to the experimental group （cord clamped at 2 minutes） and the control group （cord clamped at 15 seconds）, resuscitation effect of the two groups were compared. Results There were 21 of 2085 infants in control group and 19 of 2313 infants in experimental group found with asphyxia, the experimental group had lower rate of asphyxia and higher successful rate of resuscitation in 5 minutes compared with the control group, but there was no statistical significant difference （P〉O.05）; there was no statistical significant difference in CK-MB （P〉0.05） and lactate （P〉0.05）. But blood base excess （ BE ） improved significantly （P=0.032）. Conclusion Delayed umbilical cord clamping may improve successful rate of resuscitation and prognosis of neonates with asphyxia.