延迟脐带结扎时使用聚乙烯塑料薄膜包裹对早产儿体温乳酸的影响

目的探讨早产儿延迟脐带结扎过程中采用聚乙烯塑料包裹对体温、血糖、血气分析的影响情况.方法选择2017年5月至2019年3月本院出生,胎龄<346/7周早产儿,出生时延迟脐带结扎60s,根据出生时包裹方法不同分为聚乙烯塑料包裹组和无菌巾包裹组,分析两组早产儿入院后体温、血糖、乳酸差异.结果共纳入资料完整病例169例,聚乙烯塑料包裹组85例,无菌巾组84例.两组入院体温差异有统计学意义(P<0.05).两组入院乳酸差异有统计学意义(P=0.033),两组血糖、pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、碱剩余无明显差异(P>0.05).结论早产儿延迟脐带结扎时使用消毒的聚乙烯塑料包裹可明显提高早产儿入院后体温,减少热量丢失,减少低体温的发生,降低血乳酸水平.

Objective To investigate the effect of delayed umbilical cord clamping wraped with polyethylene plastic on admission temperature,blood gas,base excess(BE),blood glucose.Methods A total of 180 preterm infants(birth gestational age<34^6/7weeks)admitted to the NICU immediately after birth from May 2017 to March 2019 were randomly assigned to the experimental group(96infants,plastic wrap)and the control group(84infants,sterile towels wrap)with delayed cord clamping 60 seconds after birth.Infants randomized to the Platic wrap group were wrapped with polyethylene film up to their necks immediately after delivery.They were then covered with warmed blankets and transported to the NICU by the neonatal team.The control group covered with sterile towels.The effect of the two groups on admission temperature,blood glucose and lactate were compared.Results A total of 169 cases were included in the data,including 85 in the polyethylene plastic wrapping group and 84 in the sterile towel group.There was significant difference between the twp groups(P<0.05).The difference of lactate between the two groups was statistically significant(P=0.033).Conclusion Delayed cord clamping wrapped with polyethylene bags can improve admission temperature,reduce the heat loss and the incidence of hypothermia,decrease the blood lactate level.