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目的探讨不同断脐时间对早产儿血红蛋白及胆红素的影响,为改善早产儿贫血和黄疸提供临床依据。方法选择2013年12月—2014年12月在丽水市人民医院分娩的早产儿70例为研究对象。随机将70例早产儿分为晚断脐组和早断脐组各35例。早断脐组胎儿娩出后10 s内断脐,晚断脐组出生2 min后,或等待脐带搏动停止后断脐。对比2组早产儿经皮胆红素值和高胆红素血症发生率,以及血红蛋白水平(hemoglobin,Hb)和红细胞压积(hematokrit,HCT)。结果晚断脐组早产儿Hb、HCT在出生和出生后3 d分别为(168.25±13.73)g/L、(184.52±15.95)g/L、(0.51±0.04)%、(0.57±0.05)%,显著高于早断脐组(157.65±16.82)g/L、(165.04±17.31)g/L、(0.46±0.04)%、(0.50±0.04)%,差异均有统计学意义(P<0.05)。早断脐组和晚断脐组早产儿经皮胆红素测量值以及高胆红素血症发生率,差异无统计学意义(P>0.05)。结论晚断脐法不但可以提高早产儿的血容量和血红蛋白含量,有助于预防早产儿贫血,还不会增加高胆红素血症的发生率,值得临床进一步探讨和推广。
Objective To investigate the effect of different broken umbilical time on hemoglobin and bilirubin in premature infants and to provide a clinical basis for improving anemia and jaundice in premature infants. Methods From December 2013 to December 2014, 70 premature infants delivered in Lishui People’s Hospital were selected as the study objects. A total of 70 preterm infants were randomly divided into two groups, 35 cases in each group. The umbilicus was broken within 10 s after the umbilical group had been born and the umbilical umbilical group was born after 2 min after the umbilical group was born or the umbilical cord was stopped after the umbilical cord was stopped. The incidences of transcutaneous bilirubin and hyperbilirubinemia were compared between two groups of preterm infants, as well as hemoglobin (Hb) and hematokrit (HCT). Results Hb and HCT were (168.25 ± 13.73) g / L, (184.52 ± 15.95) g / L, (0.51 ± 0.04)%, (0.57 ± 0.05)% (157.65 ± 16.82) g / L, (165.04 ± 17.31) g / L, (0.46 ± 0.04)% and (0.50 ± 0.04)%, respectively, with significant difference between the two groups ). There was no significant difference in the percutaneous bilirubin and the incidence of hyperbilirubinemia among the premature babies of the early breaking umbilical cord group and the late umbilical umbilicus group (P> 0.05). Conclusion Off-line umbilicus method can not only improve the blood volume and hemoglobin content of premature children, prevent premature children anemia, but also will not increase the incidence of hyperbilirubinemia, deserving further clinical discussion and promotion.