胎盘输血对新生儿循环稳定的影响

Effects of placental transfusion on neonatal circulation stability

脐带延迟结扎(delayed cord clamping,DCC)或脐带挤勒/挤压(umbilical cord milking,UCM)能促进胎盘向新生儿输血,增加新生儿血容量,避免新生儿出生时因中断胎盘输血而造成心脏前后负荷突然变化,从而使分娩时新生儿心血管系统能够平稳、生理性过渡。虽然临床上也有胎盘输血使新生儿出现黄疸和红细胞增多症的情况出现,但有研究表明,胎盘输血并不会增加黄疸和红细胞增多症的发生率。目前,生后立即结扎脐带依然是大多数国家一直沿用的临床措施,脐带结扎的方式、影响胎盘输血的因素以及胎盘输血的利与弊仍需进一步研究。

Delayed umbilical cord clamping and umbilical cord milking could promote blood flowing from the placenta to the newborn,which would increase neonatal blood volume,avoid suddenly cardiac preload changes caused by the interruption of placental transfusion at birth,and make the neonatal cardiovascular system transition more stable and physiological.Although there have been cases of neonatal jaundice and polycythemia caused by placental transfusion in clinical,studies have shown that placental transfusion does not increase the incidence.At present,umbilical cord clamping immediately after birth is the commonly clinical practice in most countries,including China.The method of umbilical cord clamping,the factors effecting placental transfusion and the pros and cons of placental transfusion still need further research.