1.Department of Neonatology, Nanhai Sixth People′s Hospital of Foshan City, Guangdong Province, Foshan 528248,China;
2.Department of Obstetrics, Nanhai Sixth People′s Hospital of Foshan City, Guangdong Province, Foshan 528248, China;
3.Department of Ultrasonography, Nanhai Sixth People′s Hospital of Foshan City, Guangdong Province,Foshan 528248, China
摘要目的 探讨脐带结扎时间对早产儿脑室内出血的影响。方法 选取2016年9月～2018年9月于佛山市南海区第六人民医院经阴道分娩且出生时无窒息复苏的240 例早产儿作为研究对象，根据密封信封法分为对照组和实验组，每组各120 例。对照组出生后15～30 s 结扎脐带，实验组出生后30～45 s 结扎脐带。比较两组早产儿出生后的血红蛋白（Hb）、血细胞比容（Hct）、胆红素峰值水平及脑室内出血严重程度；比较两组早产儿出生后6、24、72 h脑室内出血和颅内出血的发生率。结果 实验组的Hb 水平与Hct 水平均显著高于对照组，差异有统计学意义（P<0.05）。两组的胆红素峰值水平比较，差异无统计学意义（P>0.05）；对照组出生后72 h 脑室内出血及颅内出血发生率显著高于出生后6 h 与出生后24 h，出生后24 h 脑室内出血及颅内出血发生率显著高于生后6 h，差异有统计学意义（P<0.05）；实验组出生后72 h 脑室内及颅内出血发生率显著高于出生后6 h，差异有统计学意义（P<0.05）；实验组出生后72 h 的脑室内及颅内出血发生率均显著低于对照组，差异有统计学意义（P<0.05）；出生后72 h，两组脑室内出血严重程度比较，差异无统计学意义（P>0.05）。结论 脐带结扎时间可影响早产儿脑室内出血发生率，通过合理延迟脐带结扎有利于减少早产儿脑室内出血发生风险，改善早产儿预后，提高人口素质。
Abstract：Objective To investigate the effect of umbilical cord ligation time on intraventricular hemorrhage in premature infants.Methods A total of 240 premature infants delivered via vagina and resuscitated without asphyxia at birth in the Sixth People's Hospital of Nanhai District of Foshan City from September 2016 to September 2018 were selected as the research objects, they were divided into control group and experimental group, 120 cases in each group according to the sealed envelope method.The umbilical cord was ligated 15-30 seconds after birth in the control group and 30-45 seconds after birth in the experimental group.The postnatal hemoglobin (Hb), hematocrit (Hct), peak bilirubin levels and the severity of intraventricular hemorrhage were compared between the two groups.The incidence of intraventricular hemorrhage and intracranial hemorrhage at 6, 24 and 72 hours after birth were compared between the two groups.Results The levels of Hb and Hct in the experimental group were significantly higher than those in the control group, the differences were significant (P<0.05).There was no significant difference in peak bilirubin levels between the two groups (P>0.05).The incidence of intraventricular hemorrhage and intracranial hemorrhage at 72 hours after birth in the control group was significantly higher than that at 6 hours and 24 hours after birth, and the incidence of intraventricular hemorrhage and intracranial hemorrhage at 24 hours after birth was significantly higher than that at 6 hours after birth, the differences were significant (P<0.05).The incidence of intraventricular and intracranial hemorrhage 72 hours after birth in the experimental group was significantly higher than that 6 hours after birth, the difference was significant (P<0.05).The incidence of intraventricular and intracranial hemorrhage 72 hours after birth in the experimental group was significantly lower than that in the control group, the difference was significant (P<0.05).72 hours after birth, there was no significant difference in the severity of intraventricular hemorrhage between the two groups (P>0.05).Conclusion Umbilical cord ligation time can affect the incidence of intraventricular hemorrhage in premature infants.Reasonable delay of umbilical cord ligation can reduce the risk of intraventricular hemorrhage in premature infants, improve the prognosis of premature infants and improve the quality of the population.
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