延迟结扎脐带用于新生儿免疫指标和血常规的影响及安全性分析

Effect and Safety Analysis of Delayed Umbilical Cord Ligation on Immune Indexes and Blood Routine in Neonates

目的:分析延迟结扎脐带用于新生儿免疫指标、血常规的影响及安全性。方法:选取2018年3月—2019年3月在南阳市第一人民医院出生的130例足月顺产分娩的新生儿,采用随机数表法分为两组。每组各65例,对照组出生30s内立即结扎,观察组出生至少30~60s或脐带搏动停止后结扎,比较两组新生儿1min和5minApgar评分、并发症、血常规指标、免疫指标、炎症指标及新生儿出生7d体重、智力发育评分。结果:两组新生儿1minApgar评分、总并发症率比较,差异无统计学意义(t=0.520,χ^(2)=3.693,P>0.05)。观察组新生儿5minApgar评分(9.73±0.62)分、红细胞计数(RBC)(6.94±0.72)×10^(12)/L、血红蛋白(Hb)(126.84±11.49)g/L、红细胞压积(Hct)(64.85±11.85)%、铁蛋白(5.77±1.62)g/L、免疫球蛋白G(IgG)(3.58±0.36)mg/L水平及出生7d体重(4085.22±698.63)g、智力发育评分(99.86±10.72)分高于对照组,白细胞介素-6(IL-6)(13.82±4.15)mg/L、C反应蛋白(CRP)(8.21±2.15)mg/L、肿瘤坏死因子-α(TNF-α)(4.91±1.43)mg/L水平低于对照组差异统计学意义(t=4.967、1.794、3.205,2.259、1.695、5.431、1.690、1.714、5.008、2.202、2.110,P<0.05)。结论:延迟结扎脐带可减少炎症因子的释放,提高免疫功能,促进智力发育。

Objective: To analyze the effect and safety of delayed umbilical cord ligation on immune indexes, blood routine and safety in neonates. Methods: 130 neonates who gave birth to full term delivery in the hospital from March 2018 to March 2019were randomly divided into two groups, with 65 cases in each group. The control group was ligated immediately within 30 s after birth, and the observation group was ligated at least 30-60 s or after umbilical cord pulsatile stopped. The scores of 1 min and5 min Apgar score, complications, blood routine index immune index, inflammation index, neonatal birth 7 d weight and intelligence development score were compared between the two groups. Results: There was no statistically significant difference in 1 min Apgar score and total complication rate between the two groups(t=0.520, χ^(2)=3.693, P>0.05). The 5 min Apgar score(9.73±0.62)of the observation group, red blood cell count(RBC)(6.94±0.72) × 10^(12)/L, hemoglobin(Hb)(126.84±11.49) g/L, hematocrit(Hct)(64.85±11.85)%, ferritin(5.77±1.62) g/L, immunoglobulin G(IgG)(3.58±0.36) mg/L level and 7-day birth weight(4 085.22±698.63) g, intellectual development score(99.86± 10.72) points were higher than those of the control group. Interleukin-6(IL-6)(13.82±4.15) mg/L, C-reactive protein(CRP)(8.21±2.15) mg/L, tumor necrosis factor-α(TNF-α) level(4.91±1.43) mg/L was lower than the control group, with statistically significant difference(t=4.967, 1.794, 3.205, 2.259, 1.695, 5.431, 1.690, 1.714, 5.008,2.202, 2.110, P<0.05). Conclusion: Delayed umbilical cord ligation can reduce the release of inflammatory factors, improve immune function and promote intellectual development.