延迟结扎脐带对阴道分娩早产儿的影响

Effects of delayed umbilical cord ligation on premature infants of vaginal delivery

目的:观察延迟结扎脐带对阴道分娩早产儿的影响。方法:选取104例阴道分娩早产儿为研究对象,按照随机数字表法分为对照组和观察组各52例。对照组给予即时结扎脐带,观察组予以延迟结扎脐带,比较两组血气分析指标[血液pH值、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、实际碳酸氢根(AB)]水平、血常规指标[血红蛋白(Hb)、红细胞比容(Hct)]水平,脑室周围-脑室内出血发生率和并发症发生率。结果:观察组PaO_(2)水平高于对照组,差异有统计学意义(P<0.05);两组血液pH值、PaCO_(2)、AB水平比较,差异均无统计学意义(P>0.05);出生后3 d,两组Hb、Hct水平均高于脐带结扎后2 h,且观察组高于对照组,差异有统计学意义(P<0.05);观察组周围-脑室内出血发生率为13.46%,明显低于对照组的30.77%,差异有统计学意义(P<0.05);观察组并发症发生率为3.85%,明显低于对照组的19.23%,差异有统计学意义(P<0.05)。结论:延迟结扎脐带应用于阴道分娩早产儿可提高PaO_(2)、Hb和Hct水平,以及降低周围-脑室内出血发生率和并发症发生率,优于即时结扎脐带效果。

Objective:To observe effects of delayed umbilical cord ligation on premature infants of vaginal delivery.Methods:104 premature infants of vaginal delivery were selected as the research objects,and were divided into control group and observation group according to the random number table method,52 cases in each group.The control group received immediate umbilical cord ligation,while the observation group received delayed umbilical cord ligation.The blood gas analysis index levels[blood pH,arterial partial pressure of carbon dioxide(PaCO_(2)),arterial oxygen partial pressure(PaO_(2)),actual bicarbonate(AB)],the blood routine index levels[hemoglobin(Hb),hematocrit(Hct)],the incidence of periventricular-intraventricular hemorrhage and the incidence of complications were compared between the two groups.Results:The PaO_(2) level of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the blood pH,PaCO_(2),AB levels between the two groups(P>0.05).3 days after birth,the Hb and Hct levels of the two groups were higher than 2 h after umbilical cord ligation;those of the observation group were higher than those of the control group;and the differences were statistically significant(P<0.05).The incidence of peripheral-intraventricular hemorrhage in the observation group was 13.46%,which was significantly lower than 30.77%in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 3.85%,which was significantly lower than 19.23%in the control group,and the difference was statistically significant(P<0.05).Conclusions:Delayed umbilical cord ligation for the premature infants of vaginal delivery can increase the PaO_(2),Hb and Hct levels,and reduce the incidences of peripheral-intraventricular hemorrhage and complications.Moreover,it is superior to immediate umbilical cord ligation.