不同脐带处理方式对阴道分娩早产儿贫血及高胆红素血症的影响

Effects of different umbilical cord treatment methods on anemia and hyperbilirubinemia in premature infants delivered by vagina

目的 探讨不同脐带处理方式对阴道分娩早产儿贫血及高胆红素血症的影响。方法 选取2017年1—12月在宁夏医科大学总医院新生儿重症监护病房住院的184例早产儿作为观察组,同期在银川市妇幼保健院出生的161例早产儿作为对照组。对照组早产儿出生后实施早断脐,即立即或10 s内行断脐及脐带护理;观察组根据新生儿早期基本保健技术的临床实施建议行延迟断脐及脐带护理。比较两组早产儿出生24 h、出生后1周血红蛋白、红细胞压积,以及贫血、高胆红素血症、红细胞增多症的发生率。结果 观察组早产儿出生24 h、出生后1周血红蛋白值、红细胞压积均高于对照组(P<0.05);观察组早产儿贫血的发生率低于对照组(P<0.05);两组早产儿高胆红素血症、红细胞增多症发生率比较差异无统计学意义(P>0.05)。结论 新生儿早期基本保健推荐的脐带处理方式能够提高阴道分娩早产儿不同时间血红蛋白和红细胞压积水平,降低贫血发生率,且不增加高胆红素血症和红细胞增多症的发生风险。

Objective To explore the effects of different umbilical cord treatment methods on anemia and hyperbilirubinemia in premature infants delivered by vagina.Methods A total of 184 premature infants who were hospitalized in the neonatal intensive care unit of Ningxia Medical University General Hospital from January to December 2017 were selected as an observation group,and 161 premature infants born in the Yinchuan Maternal and Child Health Hospital during the same period were selected as a control group.The preterm infants in the control group were given early umbilical cutting after birth,that is,the umbilical cord cutting and umbilical cord nursing immediately or within 10 seconds;the observation group was given delayed umbilical cutting and umbilical cord nursing according to the clinical implementation of early basic health care techniques for newborns.The hemoglobin,hematocrit,and the incidence of anemia,hyperbilirubinemia,and polycythemia were compared between the two groups at 24 hours after birth and 1 week after birth.Results The hemoglobin value and hematocrit of preterm infants in the observation group were higher than those in the control group at 24 hours after birth and 1 week after birth(P<0.05);the incidence of anemia in the observation group was lower than that in the control group(P<0.05);there was no signifi cant dif ference in the incidence of hyperbilirubinemia and polycythemia between the two groups of premature infants(P>0.05).Conclusion The umbilical cord treatment recommended in the early basic care of neonates can improve the hemoglobin and hematocrit levels of premature infants delivered vaginally at different times,reduce the incidence of anemia,and do not increase the risk of hyperbilirubinemia and polycythemia.