延迟结扎脐带对新生儿铁储备、缺铁性贫血及免疫功能的影响分析

Impact analysis of delayed ligation of umbilical cord on iron storage,iron-deficiency anemia and immune function in neonates

目的探讨延迟结扎脐带对新生儿体液免疫功能、铁储备、缺铁性贫血的影响。方法 400例产科分娩产妇按照随机数字表法分为对照组和研究组,各200例。对照组新生儿娩出后10 s内结扎脐带,研究组新生儿娩出后120 s结扎脐带。待断脐带后立即抽取血液5 ml检测新生儿血红细胞压积(HCT)、血红蛋白(Hb),4周后抽取新生儿足跟血检测HCT、Hb;并记录出生后7 d内两组新生儿经皮胆红素(TCB)水平。随访6个月,统计两组贫血及光疗情况,于新生儿出生时、出生后6个月分别检测其免疫球蛋白水平。结果两组新生儿出生后6个月时Ig M、Ig A水平与出生时相比无明显变化且组间比较,差异无统计学意义(P>0.05);两组新生儿出生后6个月时Ig G水平较出生时明显下降,且对照组下降程度较研究组显著,差异有统计学意义(P<0.05)。两组新生儿出生后4周时Hb、HCT水平明显高于出生时,且研究组出生后4周时Hb、HCT水平明显高于对照组,差异有统计学意义(P<0.05)。研究组新生儿贫血率1.0%(2/200)明显低于对照组9.0%(18/200),差异有统计学意义(χ~2=13.4737,P=0.00<0.05);研究组新生儿TCB水平为(11.63±1.87)mg/dl与对照组(11.57±1.68)mg/dl比较,差异无统计学意义(t=0.3375,P=0.73>0.05);研究组新生儿光疗率4.0%与对照组6.0%比较,差异无统计学意义(χ~2=0.8421,P=0.35>0.05)。结论延迟结扎脐带可有利于预防新生儿贫血,同时还可促使更多免疫因子等进入新生儿体内而增强其免疫功能。

Objective To explore the impact of delayed ligation of umbilical cord on iron storage,irondeficiency anemia and immune function in neonates.Methods A total of400obstetrics delivery maternal women were divided by random number table method into control group and research group,with200cases in each group.The control group received ligation of umbilical cord within10s of neonates delivery,and the research groupreceived ligation of umbilical cord within120s of neonates delivery.Collection of5ml blood immediately after umbilical cord was removed,and detection were made on its hematocrit(HCT),hemoglobin(Hb).4weeks later,detection were made on HCT,Hb of neonatal heel blood,and transcutaneous bilirubin(TCB)level within postnatal7d was recorded in two groups.Statistics of anemia and phototherapy were collected after6months of followup,and immunoglobulin(Ig)level was detected at birth and6months after birth.Results Both groups had noobvious changes in IgM and IgA level6months after birth than at birth,and there was no statistically significant difference between two groups(P>0.05).Both groups had obviously lower IgG level6months after birth than atbirth,but the control group had more significant decline than the research group,and the difference had statisticalsignificance(P<0.05).Both groups had higher Hb and HCT level4weeks after birth than at birth,and the researchgroup had obviously higher Hb and HCT level than the control group.The difference had statistical significance(P<0.05).The research group had obviously lower anemia rate as1.0%(2/200)than9.0%(18/200)in the controlgroup,and the difference had statistical significance(χ2=13.4737,P=0.00<0.05).The research group had nostatistically significant difference in TCB level as(11.63±1.87)mg/dl,comparing with(11.57±1.68)mg/dl in thecontrol group(t=0.3375,P=0.73>0.05).The research group had no statistically significant difference in neonatalphototherapy rate as4.0%,comparing with6.0%in the control group(χ2=0.8421,P=0.35>0.05).ConclusionDelayed ligation of umbilical cord is of great benefit to prevent neonatal anemia,as well as promotion of moreimmune factor into newborns newborn body and enhance their immune function.