胎盘输血技术发展现状

Current research status of placental transfusion

胎盘输血对新生儿的益处已得到广泛证实,既可以补充新生儿血容量,改善生后早期脏器灌注,有利于胎儿血循环向新生儿血循环过渡,也可以减少输血治疗需求,促进新生儿出生时建立适应的生理机制和功能,降低新生儿颅内出血(ICH)、坏死性小肠结肠炎、支气管肺发育不良等并发症发生率。同时,还可增加新生儿血清铁储备,改善神经系统疾病新生儿远期预后,降低新生儿死亡率。本文涉及的胎盘输血措施主要包括新生儿分娩时采取延迟脐带结扎(DCC)和脐带挤压(UCM)。根据世界卫生组织等权威机构推荐,对多数有活力足月新生儿和早产儿应采取DCC措施,达到胎盘输血的目的。笔者拟对胎盘输血的:①生理学基础;②对新生儿影响;③当前对其研究的重点方向等最新研究现状进行阐述。

The multiple benefits of placental transfusion for neonates have been widely confirmed.This procedure can replenish blood volume,improve organ perfusion in the early postnatal stage,facilitate the transition from fetal to neonatal circulation.Placental transfusion can reduce the demand for blood transfusion,promote the physiological mechanism and function of neonatal adaptation at birth,and the onset of intracranial hemorrhage(ICH),necrotizing enterocolitis,bronchopulmonary dysplasia and other complications.It can also improve serum iron reserve and long-term prognosis of central nervous system,and reduce infant mortality.Placental transfusion in this article consists of delayed cord clamping(DCC)and umbilical cord milking(UCM).Routine use of DCC at birth for most vigorous term or preterm infants is recommended by World Health Organization.The author intends to expound on physiological basis of placental transfusion,effects of placental transfusion on neonates,and key directions of current research of placental transfusion.