晚断脐对早产儿结局的影响

Effect of Late off umbilical on premature infant

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（χ^2=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。

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 （χ^2=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.