不同脐带结扎方式对早产儿血氧饱和度、血流动力学的影响比较
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摘要
目的比较延迟脐带结扎及常规脐带结扎对早产儿血氧饱和度、血流动力学的影响。方法选取2017年2月～2018年4月期间浙江省永康市妇幼保健院产科出生的早产儿,按照脐带结扎方法,常规脐带结扎法、延迟脐带结扎法各纳入50例,分别纳入对照组、实验组。比较两组早产儿出生后10 min心率、经皮血氧饱和度(SpO_2),出生24 h血常规指标[血红蛋白(Hb)、红细胞压积(Hct)、红细胞计数(RBC)],脑血流动力学指标[双侧MCA收缩期最大流速(Vs)、舒张期末期流速(V_d)、阻力指数(RI)、平均血流速度(Vm)]以及新生儿神经行为测定(NBNA)评分。结果产后10 min,实验组早产儿心率低于对照组,SpO_2高于对照组(P<0.05);实验组早产儿出生24 h Hb、RBC、HCT均高于对照组(P均<0.05);两组早产儿出生24 h Vs、V_d、RI、Vm比较差异无统计学意义(P均>0.05),实验组NBNA评分明显高于对照组(P<0.05)。结论延迟脐带结扎可有利于提高早产儿SpO_2,改善血常规指标以及行为神经功能,对早产儿脑血流动力学指标无影响。
Objective To compare the effects of delayed umbilical cord ligation and conventional umbilical cord ligation on oxygen saturation and hemodynamics in premature infants. Methods From February 2017 to April 2018, 50 cases of premature infants born in obstetrics department of Yongkang Maternal and Child Health Hospital were enrolled in the control group and the experimental group according to umbilical cord ligation method, conventional umbilical cord ligation method and delayed umbilical cord ligation method. The heart rate, percutaneous oxygen saturation(SpO_2), blood routine parameters[hemoglobin(Hb), hematocrit(Hct), red blood cell count(RBC)], cerebral hemodynamic parameters [maximum systolic flow rate(Vs), end diastolic flow rate(Vd), resistance index(RI)of two groups of premature infants at 10 minutes after birth were compared. Average blood flow velocity(Vm)and neonatal neurobehavioral assessment(NBNA)score. Results10 minutes after delivery, the heart rate of preterm infants in the experimental group was lower than that in the control group,SpO_2 was higher than that in the control group(P<0.05); the Hb, RBC and HCT of preterm infants in the experimental group were higher than those in the control group(P<0.05); there was no significant difference in the Vs, Vd, RI and Vm of preterm infants in the two groups(P>0.05); the NBNA score of the experimental group was significantly higher than that of the control group(P<0.05). Conclusion Delayed umbilical cord ligation can improve SpO_2, blood routine parameters and behavioral neurological function in premature infants, but has no effect on cerebral hemodynamic parameters in premature infants.
Objective To compare the effects of delayed umbilical cord ligation and conventional umbilical cord ligation on oxygen saturation and hemodynamics in premature infants. Methods From February 2017 to April 2018, 50 cases of premature infants born in obstetrics department of Yongkang Maternal and Child Health Hospital were enrolled in the control group and the experimental group according to umbilical cord ligation method, conventional umbilical cord ligation method and delayed umbilical cord ligation method. The heart rate, percutaneous oxygen saturation(SpO_2), blood routine parameters[hemoglobin(Hb), hematocrit(Hct), red blood cell count(RBC)], cerebral hemodynamic parameters [maximum systolic flow rate(Vs), end diastolic flow rate(Vd), resistance index(RI)of two groups of premature infants at 10 minutes after birth were compared. Average blood flow velocity(Vm)and neonatal neurobehavioral assessment(NBNA)score. Results10 minutes after delivery, the heart rate of preterm infants in the experimental group was lower than that in the control group,SpO_2 was higher than that in the control group(P<0.05); the Hb, RBC and HCT of preterm infants in the experimental group were higher than those in the control group(P<0.05); there was no significant difference in the Vs, Vd, RI and Vm of preterm infants in the two groups(P>0.05); the NBNA score of the experimental group was significantly higher than that of the control group(P<0.05). Conclusion Delayed umbilical cord ligation can improve SpO_2, blood routine parameters and behavioral neurological function in premature infants, but has no effect on cerebral hemodynamic parameters in premature infants.
引文
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[2]葛迎年,童笑梅,刘云峰.输血对贫血早产儿脑血流动力学及脑损伤的影响研究[J].中国新生儿科杂志,2014,29(2):78-81.
[3]李星,常颖,陈叙.延迟脐带结扎对新生儿及产妇的影响[J].国际妇产科学杂志,2016,43(3):295-297,311.
[4]郭芳,朱进秋,罗维真,等.脐带结扎方式对早产儿并发症的影响[J].中华新生儿科杂志,2014,29(6):386-389.
[5]王振辉.延迟断脐对早产儿预后的影响[J].医学临床研究,2016,33(12):2389-2391.
[6]陈远春,宋燕,宋波萍.新生儿的脐带结扎时机研究[J].检验医学与临床,2017,14(1):106-108.
[7]张莉,李占魁.脐带结扎时间与新生儿结局的研究进展[J].中华围产医学杂志,2013,16(12):747-749.
[8]邓曦,潘淑媛,曾韶英.不同脐带结扎时间对母儿结局的影响[J].中国医药导报,2017,14(2):89-92.
[9]李星,常颖,陈叙,等.延迟脐带结扎对足月儿血氧饱和度影响的研究[J].中国妇幼保健,2016,31(5):1098-1100.
[10]张红琴,陈俊.延迟脐带结扎对新生儿血红蛋白及黄疸的影响[J].广东医学,2017,38(23):3626-3627.
[11]马杏娟,周小英,褚亚苏,等.延迟脐带结扎对婴幼儿贫血的影响[J].中华全科医学,2016,14(11):1965-1966,1970.
[12]王振辉.延迟断脐对早产儿预后的影响[J].医学临床研究,2016,33(12):2389-2391.