比较胎儿娩出后结扎脐带时机对铁储备的影响

Study on the effect of different intervals for ligation of umbilical cord on iron reservation of neonates after delivery

目的比较胎儿娩出后2-3 min与30 s内结扎脐带对缺铁性贫血及铁储备的影响。方法选取产科分娩新生儿361例为研究对象,依照胎儿娩出结扎脐带时间分为晚结扎组181例和早结扎组180例,晚结扎组胎儿娩出后2-3 min结扎脐带,早结扎组胎儿娩出后30 s内结扎脐带,分析两组新生儿铁储备以及缺血性贫血情况。结果出生3天晚结扎组血红蛋白（Hb）（186.25±15.26）g/L、血细胞比容（Hct）（0.54±0.03）%,显著高于早结扎组（165.26±16.82,0.51±0.05）（P0.05）。4月龄晚结扎组和早结扎组红细胞平均体积（MCV）差异无显著性（P〉0.05）;晚结扎组血清铁蛋白（SF）水平（52.75±0.73）g/L显著高于早结扎组（27.59±1.26）g/L,P0.05）,晚结扎组SF水平低于早结扎组,但差异无显著性（P〉0.05）。两组患者产后大出血发生率、新生儿红细胞增多症发生率以及新生儿光疗比率差异无显著性（P〉0.05）;但晚结扎组高胆红素血症发生率（18.8%）显著低于早结扎组（38.3%,P〈0.05）。结论在胎儿娩出时,延迟结扎脐带能够提高新生儿铁储备,减少缺血性贫血情况,对新生儿生长发育有利。

Objective To compare the effect of umbilical cord ligation of neonates in 2-3 min and 30 sec after delivery on iron deficiency anemia and iron reservation. Methods A total of 361 delivered neonates in the department of obstetrics were selected for this study,and all these neonates were divided into late ligation group（ 181 cases） and early ligation group（ 180 cases） according to the time for ligation of umbilical cord.The condition of iron reservation and iron deficiency anemia in neonates were analyzed and compared between these two groups. Results In three days after birth,Hb（ 186. 25 ± 15. 26） g / L and hematocrit（ Hct）（ 0. 54 ± 0. 03） in neonates of later ligation group were significantly higher than those of neonates in early ligation group（ P〈0. 05）,and the incidence rate of anemia in neonates of later ligation group was 0,it was significantly lower than that（ 4. 4%） of neonates in early ligation group（ P〈0. 05）,and the difference in other indicators between these two groups was not significant（ P〈0. 05）. The difference in level of MCV in neonates at age of 4 months was not statistically significant between these two groups（ P〈0. 05）. The difference in levels of serum ferritin（ SF）（ P〈0. 05）,Hct,Hb and MCV was not statistically significant between these two groups in 6 months after birth（ P〈0. 05）,the level of SF in later ligation group was lower than that of early ligation group,but the difference was not statistically significant（ P〈0. 05）. The incidence rate of postpartum hemorrhage and the increase of count of red blood cells in neonates were not significantly different between these two groups（ P〈0. 05）. The incidence of hyperbilirubinemia（ 18. 8 %） in neonates of later ligation group was significantly lower than that（ 38. 3%） of neonates in early ligation group（ P〈0. 05）. Conclusion The delayed ligation of umbilical cord in neonates can raise the iron reservation and reduce the incidence of iron deficiency anemia,and it is beneficial for the growth and development of neonates.