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目的分析挤压脐带的胎盘输血方法对极低出生体重(VLBW)早产儿的影响。方法 120例VLBW早产儿,根据出生时间分为观察组和常规组,各60例。观察组出生后立即采取挤压脐带的胎盘输血方法 ,常规组采取常规结扎脐带。对比观察两组并发症、输血情况、肺泡表面活性物质(PS)的使用情况、治疗和预后情况。结果观察组重度窒息、贫血、侧脑室出血、呼吸窘迫综合征发生率11.67%、50.00%、21.67%、33.33%均低于常规组26.67%、73.33%、40.00%、51.67%(P<0.05),两组红细胞增多症、支气管肺发育不良、视网膜病变、败血症发生率比较差异无统计学意义(P>0.05)。观察组输血比例43.33%、PS使用率56.67%和死亡率15.00%明显低于常规组68.33%、71.67%、28.33%(P<0.05)。观察组吸氧时间(14.5±5.2)d、输血量(6.1±0.2)ml/kg和机械通气时间(7.9±0.5)d均低于常规组(17.8±6.8)d、(8.1±0.2)ml/kg、(8.5±0.7)d(P<0.05)。结论对VLBW早产儿采取挤压脐带的胎盘输血方法可以明显减少出现严重并发症,减少输血次数、机械通气时间,降低死亡率,有利于改善VLBW早产儿的预后。
Objective To analyze the effects of placental transfusion with umbilical cord compression on preterm infants with very low birth weight (VLBW). Methods 120 cases of VLBW preterm children, according to the birth time was divided into observation group and conventional group, 60 cases each. The observation group was born immediately after taking the umbilical cord placental transfusion method, the conventional group to take routine ligation of the umbilical cord. The complication, blood transfusion, usage of alveolar surfactant (PS), treatment and prognosis were compared between the two groups. Results The incidences of severe asphyxia, anemia, lateral ventricle hemorrhage and respiratory distress syndrome were 11.67%, 50.00%, 21.67% and 33.33% in the observation group, which were significantly lower than those in the control group (26.67%, 73.33%, 40.00% and 51.67%, P <0.05) There was no significant difference between the two groups in the incidence of polycythemia, bronchopulmonary dysplasia, retinopathy and sepsis (P> 0.05). In the observation group, the blood transfusion rate was 43.33%, the PS usage rate was 56.67% and the mortality rate was 15.00%, which was significantly lower than that of the conventional group (68.33%, 71.67%, 28.33%, P <0.05). Oxygen inhalation time (14.5 ± 5.2) d, blood transfusion volume (6.1 ± 0.2) ml / kg and mechanical ventilation time (7.9 ± 0.5) d in the observation group were all lower than those in the conventional group (17.8 ± 6.8) d / kg, (8.5 ± 0.7) d (P <0.05). Conclusions The placental transfusion method of squeezing the umbilical cord in VLBW premature infants can significantly reduce the occurrence of serious complications, reduce the number of transfusions, the duration of mechanical ventilation, reduce the mortality rate and improve the prognosis of VLBW premature infants.