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目的探讨不同脐带结扎方式对早产儿并发症的影响。方法选择2011年9月至2013年12月本院产科顺产出生的早产儿,分别按挤压脐带、延迟脐带结扎及常规脐带结扎三种方法结扎脐带,每组各纳入100例,对3组早产儿出生12~24 h的Hb、Hct和部分并发症发生情况进行比较分析。结果延迟脐带结扎组Hb(g/L)高于挤压脐带组和常规脐带结扎组[(204±25)比(196±16)、(185±12)],挤压脐带组高于常规脐带结扎组;延迟脐带结扎组Hct(%)高于常规脐带结扎组[(67.5±3.0)比(65.9±3.2)],差异有统计学意义(P<0.05)。挤压脐带组和延迟脐带结扎组发生败血症、坏死性小肠结肠炎(NEC)和贫血的比例均少于常规脐带结扎组(败血症:11%、13%比24%,NEC:6%、5%比15%,贫血:21%、12%比37%),差异有统计学意义(P<0.05),挤压脐带组和延迟脐带结扎组差异无统计学意义(P>0.05);各组发生RDS、颅内出血、呼吸暂停、红细胞增多症、高胆红素血症、新生儿出血症、早产儿视网膜病(ROP)、支气管肺发育不良(BPD)的比例差异均无统计学意义(P>0.05)。挤压脐带组和延迟脐带结扎组住院时间(天)和住院费用(万元)均低于常规脐带结扎组[住院时间:(28.7±1.5)比(32.4±1.3)、(36.2±1.4),住院费用:(3.1±0.2)比(3.2±0.4)、(3.9±0.3)],挤压脐带组低于延迟脐带结扎组,差异有统计学意义(P<0.01)。结论挤压脐带和延迟脐带结扎可减少早产儿部分并发症的发生,降低住院时间和费用,易于临床开展,有利于改善早产儿预后。
Objective To investigate the effect of different umbilical cord ligation methods on the complications of premature infants. Methods From September 2011 to December 2013, the obstetric-born preterm infants in our obstetric department were enrolled in this study. The umbilical cord was ligated by pressing the umbilical cord, delaying the umbilical cord ligation and conventional umbilical cord ligation. Each group included 100 cases, Children born 12 ~ 24 h of Hb, Hct and some complications occurred comparative analysis. Results Hb (g / L) in the umbilical cord ligation group was significantly higher than that in the umbilical cord group and the conventional umbilical cord ligation group [(204 ± 25) vs (196 ± 16), (185 ± 12)], (P <0.05). The percentage of Hct (%) in delayed umbilical cord ligation group was significantly higher than that in conventional umbilical cord ligating group [(67.5 ± 3.0) vs (65.9 ± 3.2)], the difference was statistically significant (P <0.05). The rates of sepsis, necrotizing enterocolitis (NEC) and anemia in the umbilical cord and delayed umbilical cord ligation groups were less than those in the conventional umbilical cord ligation group (sepsis: 11%, 13% vs 24%, NEC: 6%, 5% (P <0.05). There was no significant difference between the umbilical cord compression group and the delayed umbilical cord ligating group (P> 0.05) RDS, intracranial hemorrhage, apnea, polycythemia, hyperbilirubinemia, neonatal hemorrhagic disease, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) were not significantly different (P> 0.05). The hospital stay (days) and hospitalization costs (10,000 yuan) in the umbilical cord compression group and the delayed umbilical cord ligation group were both lower than those in the conventional umbilical cord ligation group [hospitalization time (28.7 ± 1.5) vs (32.4 ± 1.3), (36.2 ± 1.4) Hospitalization costs were (3.1 ± 0.2) vs (3.2 ± 0.4), (3.9 ± 0.3), respectively. There was a significant difference between the umbilical cord group and the umbilical cord ligation group (P <0.01). Conclusions Squeezing the umbilical cord and delaying the umbilical cord ligation can reduce the incidence of some complications in premature infants, reduce the length of hospital stay and costs, facilitate the clinical implementation, and improve the prognosis of preterm infants.