延迟断脐在早产儿的应用观察

Application of delayed umbilical cord separation in delivery of preterm infant

目的研究延迟断脐对早产儿的影响。方法对因患重度子痫前期疾病在孕28周至37周间剖宫分娩的早产儿采取延迟断脐的方法处理脐带,观察延迟断脐对早产儿的红细胞压积、血红蛋白浓度及出生后血气氧分压和二氧化碳分压的影响;探讨目前有争议的延迟断脐是否增加早产儿病理性黄疸的发生率。结果观察组中早产儿的血红蛋白为(167.3±27.4)g/L;红细胞压积为(51.3±8.67)%;贫血13例,占20.97%;发生病理性黄疸24例,占38.7%;氧分压为(82.4±9.67)mm Hg;二氧化碳分压为(45.6±3.73)mm Hg。对照组中早产儿的血红蛋白为(158.6±21.8)g/L;红细胞压积为(48.8±4.93)%;贫血25例,占38.46%;发生病理性黄疸21例,占32.3%;氧分压为(79.1±8.32)mm Hg;二氧化碳分压为(47.2±4.28)mm Hg。两组早产儿的血红蛋白、红细胞压积、发生贫血的比率、氧分压及二氧化碳分压方面有显著差异(P<0.05),在病理性黄疸方面差异无统计学意义(P>0.05)。结论采取延迟断脐可减少早产儿贫血的发生率,改善早产儿的氧分压及二氧化碳分压,不增加发生病理性黄疸的几率。

Objective：To observe the clinical effect of delayed umbilical cord separation in delivery of preterm infant. Methods：Assess the effect of delayed umbilical cord separation on hemorrhage amount during delivery and on blood volume,hemoglobin concentration and oxygen partial pressure of the preterm infant,and to investigate the currently controverted opinion whether delayed umbilical cord separation can increase incidence of pathologic jaundice in preterm infant. Results：Effect of delayed umbilical cord separation on the preterm infant：the hemoglobin concentration of preterm infants in the observation group was 167.3±27.4g/L,hematocrit 51.3±8.67%,13 cases with anemia（20.97%）,24 case with pathologic jaundice（38.7%）;oxygen partial pressure 82.4±9.67 mm Hg,and carbon dioxide partial pressure 45.6±3.73 mm Hg. The hemoglobin concentration of preterm infants in the control group was 158.6±21.8g/L,hematocrit 48.8±4.93%,25 cases with anemia（38.46%）,21 case with pathologic jaundice（32.3%）,oxygen partial pressure 82.4±9.67 mm Hg,and carbon dioxide partial pressure 45.6±3.73 mm Hg. The two groups of preterm infants showed significant differences in hemoglobin concentration,hematocrit,anemia ratio,oxygen and carbon dioxide partial pressure（P〈0.05）,but no significant difference in ratio of pathologic jaundice（P〉0.05）. Conclusion：Delayed umbilical cord separation can reduce incidence of anemia and improve oxygen and carbon dioxide partial pressure of preterm infant without increasing risk of pathological jaundice.