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目的探讨延迟脐带结扎对婴幼儿贫血的影响研究,为降低临床婴幼儿贫血率提供依据。方法选择2015年1月—2016年6月在余姚市第二人民医院分娩的单胎妊娠阴道分娩产妇180例,将产妇随机分为实验组97例、对照组83例,对照组新生儿采取常规脐带结扎(娩出10 s内结扎),实验组新生儿延迟脐带结扎(娩出2 min结扎),比较2组新生儿娩出1 min以及5 min的Apgar评分,出生后24 h、出生后4周以及出生后4个月时的血红蛋白(Hb)以及红细胞比容(HCT),出生后3 d的经皮胆红素水平,以及接受光疗的平均天数、贫血率及输血率。结果 2组新生儿出生后1 min、5 min Apgar评分差异均无统计学意义(P>0.05);实验组新生儿出生后24 h、4周以及4个月血红蛋白水平以及红细胞比容均显著高于对照组(P<0.05);2组新生儿经皮胆红素水平以及光疗天数比较差异无统计学意义(P>0.05);实验组新生儿贫血率以及输血率均显著低于对照组(P<0.05)。结论延迟脐带结扎能够有效升高婴幼儿血红蛋白含量,增加了机体的铁储备量,并减少婴幼儿生理性贫血的发生率,而对新生儿胆红素水平及Apgar评分未发现明显不良影响,是改善婴幼儿贫血的一种简单、安全的手段。
Objective To investigate the effects of delayed umbilical cord ligation on anemia in infants and young children and to provide evidence for reducing the anemia in infants and young children. Methods One hundred and eighty pregnant women with vaginal delivery of singleton pregnancy delivered from January 2015 to June 2016 in Yuyao Second People’s Hospital were randomly divided into experimental group (n = 97) and control group (n = 83). The control group adopted routine Umbilical cord ligation (ligation within 10 s), neonatal ligation of the umbilical cord in the experimental group (2 min ligation), Apgar score at 1 min and 5 min after birth, 24 h after birth, 4 weeks after birth and birth Hemoglobin (Hb) and hematocrit (HCT) after 4 months, transdermal bilirubin level 3 days after birth, and the average number of days receiving phototherapy, anemia and blood transfusion rate. Results There was no significant difference in Apgar scores at 1 minute and 5 minutes after birth between the two groups (P> 0.05). The levels of hemoglobin and hematocrit were significantly higher at 24 h, 4 and 4 months after birth (P <0.05). There was no significant difference in transdermal bilirubin level and days of phototherapy between the two groups (P> 0.05). The rate of neonatal anemia and blood transfusion in the experimental group were significantly lower than those in the control group P <0.05). Conclusion Delayed umbilical cord ligation can effectively increase the hemoglobin content of infants and young children, increase the body’s iron reserve, and reduce the incidence of infant’s physiological anemia, while no significant adverse effects on neonatal bilirubin levels and Apgar scores were found A simple, safe way to improve anemia in infants and young children.