DOI:网络出版地址:[收稿日期]2010灢09灢30暋暋[修回日期]2010灢10灢15暋暋网络出版时间:暶[基金项目]海南省卫生厅科研基金资助项目(琼卫2007灢55)[作者简介]华少萍(1962灢),女,海南文昌人,副主任医师,Tel:13807653238。[通讯作者]张宏玉,南方医科大学在职博士,副教授,Tel:13158942317,Email:hong1029@sohu.com。断脐时间对母儿结局的影响华少萍1,张宏玉2*,周暋红3,郑思华1,陈暋蔚1,谢春丽1(海南医学院1.附属医院妇产科,2.国际护理学院,海南海口暋571100;3.杭州市人民医院妇产科,浙江杭州暋310000)暋暋[摘要]目的:探讨断脐时间对母儿结局的影响。方法:176例产妇随机分为两组,试验组进行晚断脐(等待脐带搏动停止后),对照组按目前临床常规执行早断脐(生后少于10s),比较两组产后出血量、新生儿脐血血红蛋白、生后最高1次胆红素值、新生儿Apgar评分及是否贫血、是否需要光疗等母儿结局。结果:足月儿127例,早产儿49例,足月儿两组脐血血红蛋白浓度及新生儿1分钟、5分钟Apgar评分均无统计学差异(P>0.05),试验组产后出血量及出生后最高1次胆红素水平明显低于对照组(P<0.05);早产儿两组母儿结局各指标差异均无统计学意义(P>0.05);足月儿和早产儿两组新生儿贫血和需要光疗者所占比例均无统计学差异(P>0.05)。结论:晚断脐(等待脐带搏动停止后断脐)比早断脐(生后10s)有更少的产后出血量,不增加新生儿胆红素水平,未显示晚断脐对母儿结局有不良影响,分娩应遵循自然规律,等待脐带搏动停止后断脐,以防止过早断脐可能的潜在不良影响。[关键词]晚断脐;早断脐;新生儿贫血;新生儿高胆红素血症[中图分类号]R726暋[文献标识码]A暋[文章编号]1007灢1237(2010)12灢灢EffectoftimeofclampingumbilicalcordonoutcomeofmothersandnewbornsHUAShao灢ping1,ZHANGHong灢yu2,ZHOUHong3,ZHANGSi灢hua1,CHENWei1,XIEChun灢li1(1.DepartmentofGynecology,AffiliatedHospitaltoHainanMedicalUniversity,Haikou571100,China;2.InternationalNursingSchool,HainanMedicalUniversity,Haikou571100,China;3.DepartmentofGynecology,HangzhouPeople曚sHospital,Hangzhou310000,China)[FoundationProject]:SupportedbyFoundationofHainanHealthCommittee(2007灢55)[Author]:HUAShao灢ping(1962灢),Female,WenchangHainan,AssociateChiefPhysician,Tel:13807653238.[Correspondenceto]:ZHANGHong灢yu,AssociateProfessor,M.D.,Tel:13158942317,Email:hong1029@sohu.com.Received:2010灢09灢30暋暋Revised:2010灢10灢15JHMC,2010;16(12):灢Viewfromspecialist:Itiscreative,andofcertainscientificandeducationalvalue.[ABSTRACT]Objective:Toexploretheeffectoftimeofclampingumbilicalcordonoutcomeofmoth灢ersandnewborns.Methods:Atotalof176pregnantwomenwererandomlydividedintotwogroups:ex灢perimentalgroupwithlateumbilicalcordclampingafterpulsationarrest,andcontrolgroupreceivingearlyclampingin10safterborn.Thebleedingvolume,hemoglobininnewborncordblood,thehighestbilirubinCNKI:46-1049/R.20101209.1150.0192010-12-0911:50http://www.cnki.net/kcms/detail/46.1049.R.20101209.1150.019.htmlafterbirth,Apgarscore,andmaternalandnewbornoutcomesuchastheoccurrenceofneonatalanemia,applicationofphototherapy,etcintwogroupswerecompared.Results:Therewere127terminfantsand49preterminfants.Therewerenosignificantdifferencesinhemoglobinlevelofterminfants,orApgarscoreatthe1standthe5thminuteafterbirthinbothgroup(P>0.05).Bleedingvolumeafterdeliveryandthehighestbilirubinlevelweresignificantlylowerinexperimentalgroup(P<0.05).Moreover,therewasnosignificantdifferenceinoutcomeofmothersandnewbornsbetweentwopretermgroupsandbe灢tweenpretermandtermgroups(P>0.05).Conclusions:Thebleedingvolumedecreasedandbilirubinlevelincreasedinnewbornswithlateumbilicalcordclamping.Itshowsnosideeffectonoutcomeofmothersandnewborns.Theumbilicalcordclampingshouldbeemployedafterpu...
