延迟脐带结扎对新生儿黄疸、红细胞增多症及对睡眠障碍的影响研究(1)

http://www.100md.com 2018年9月1日 《世界睡眠医学杂志》 20189

     摘要 目的：探讨延迟结扎脐带对新生儿黄疸及红细胞增多症的影响。方法：选取2016年3月至2018年2月武警福建总队医院收治的足月分娩新生儿90例，采用随机数字表法分为对照组和观察组，每组45例。对照组新生儿分娩后10 s内结扎脐带，观察组应用延迟2 min结扎脐带。比较2组足月分娩新生儿黄疸发生率、高胆红素血症发生率、胆红素脑病发生率、睡眠障碍发生率；出生后第3天经皮胆红素的水平；红细胞压积平均值；红细胞增多症发生率。结果：观察组足月分娩新生儿黄疸发生率、高胆红素血症发生率、胆红素脑病发生率、睡眠障碍发生率和对照组比较，差异无统计学意义(P>0.05)；观察组出生后第3天经皮胆红素的水平高于对照组，差异无统计学意义(P>0.05)；观察组红细胞压积平均值高于对照组，差异有统计学意义(P<0.05)。观察组红细胞增多症发生率高于对照组，差异有统计学意义(P<0.05)。结论：延迟2 min结扎脐带在足月分娩新生儿中应用对黄疸、高胆红素血症、睡眠无明显影响，但可导致红细胞增多症发生率升高。

    关键词 延迟结扎脐带；新生儿黄疸；红细胞增多症；睡眠质量

    中图分类号：R722.17文献标识码：Adoi：10.3969/j.issn.2095-7130.2018.09.017

    Abstract Objective：To explore the effect of delayed ligation of umbilical cord on neonatal jaundice and polycythemia.Methods：90 cases of full term birth from March 2016 to February 2018 were divided into 2 groups by random number table.The control group ligatured the umbilical cord within 10 seconds after delivery，and the experimental group ligatured the umbilical cord with a delay of two second after delivery.The incidence of jaundice，the incidence of hyperbilirubinemia，the incidence of bilirubin encephalopathy，the incidence of sleep disorders，the level of percutaneous bilirubin on the third day after birth，the average value of hematocrit and the incidence of erythrocytosis were compared between the two groups of full term birth.Results：The incidence of jaundice，the incidence of hyperbilirubinemia，the incidence of bilirubin encephalopathy and the incidence of sleep disorders in the experimental group at full-term delivery were not significantly different from those in the control group.，P>0.05； The level of bilirubin in the experimental group on the third day after birth was higher than that in the control group，but the difference was not significant P>0.05.The mean value of hematocrit in the experimental group was higher than that in the control group，P<0.05.The incidence of erythrocytosis in the experimental group was higher than that in the control group，P<0.05.Conclusion：The delayed 2 minute ligation of umbilical cord has no obvious effect on jaundice，hyperbilirubinemia and sleep，but it can increase the incidence of polycythemia.

    Key Words Delayed ligation of umbilical cord； Neonatal jaundice； Polycythemia； Sleep quality

    新生兒娩出后脐带结扎方式过去一直使用快速脐带结扎，认为其有利于新生儿抢救，并且也可以降低高胆红素血症的发生率。近年来，有学者提出脐带结扎应该推迟。研究认为，延迟脐带结扎对新生儿有明显好处，可增加新生儿血红蛋白水平，促使其增加铁储备，从而规避贫血的发生，并可减少坏死性小肠结肠炎的发病率，还可降低其他并发症风险。但目前关于2种方式孰优孰劣仍存在争议[1-2]。本研究分析了延迟结扎脐带对新生儿黄疸及红细胞增多症的影响，现将结果报道如下。

    1 资料与方法

    1.1 一般资料 选取2016年3月至2018年2月武警福建总队医院收治的足月分娩新生儿90例，采用随机数字表法分成2组，每组45例。观察组年龄21～35岁，平均年龄(28.24±2.13)岁。孕龄37～42周，平均孕周(39.22±2.65)周；对照组年龄21～35岁，平均年龄(28.21±2.12)岁。孕龄37～42周，平均孕周(39.20±2.61)周；2组一般资料比较，差异无统计学意义(P>0.05)，具有可比性，产妇和新生儿均无并发症。(孟祥辉 韩计亮)

第 1 2 页 下一页

    百拇医药网 http://www.100md.com/html/paper/2095-7130/2018/09/17.htm