延迟脐带结扎对足月经阴道分娩母婴结局影响的研究-现代医学

延迟脐带结扎对足月经阴道分娩母婴结局影响的研究

单位：东南大学附属中大医院妇产科, 江苏南京 210009

分类号：R714.56

出版年·卷·期（页码）：2022·50·第一期（101-104）

摘要：

目的：研究延迟脐带结扎对足月经阴道分娩母婴结局的影响。方法：选取2019年6个月的我科足月经阴道分娩的产妇及新生儿332例为对照组，出生后立即脐带结扎；2020年6个月的我科足月经阴道分娩的产妇及新生儿285例为试验组，脐带搏动停止后脐带结扎。对比分析两组足月经阴道分娩产妇第3产程时长、产后24 h阴道出血量、新生儿出生时即刻血糖、出生后第3天总胆红素水平、脐带残端脱落时间及并发症发生率。结果：第3产程时长试验组为(6.41±1.45)min，对照组为(6.02±1.34)min，两组产妇第3产程时长差异无统计学意义(P>0.05)；试验组产后24 h出血量为(287.54±112.45)ml，少于对照组的(328.42±121.96)ml，差异有统计学意义(P＜0.05)；新生儿出生后即刻血糖试验组为(4.34±0.84)mmol·L^-1，少于对照组的(3.92±0.78)mmol·L^-1，差异有统计学意义(P<0.05)；新生儿出生后第3天总胆红素值试验组为(6.43±1.44)μmol·L^-1，对照组为(6.42±1.43)μmol·L^-1，差异无统计学意义(P>0.05)；新生儿脐带残端脱落时间试验组为(8.24±1.92)d，少于对照组的(9.48±2.28)d，差异有统计学意义(P<0.05)；新生儿脐部并发症发生率试验组为2.10%，少于对照组的6.62%，差异有统计学意义(P<0.05)。结论：延迟脐带结扎在减少产妇产后24 h阴道出血量、降低新生儿出生后低血糖的发生、加快脐带脱落及减少脐部并发症方面具有积极意义，但其与新生儿黄疸的发生风险之间关系尚须进一步研究。

Objective:To study the effect of delayed umbilical cord ligation on the maternal and infant outcome of full-term vaginal delivery.Methods:A total of 332 cases of parturients and neonates whodelivered vaginal delivery at 6 monthsin our department in 2019 were selected as the control group, andumbilical cord ligation was performed immediately after birth.In 2020, 285 cases ofparturients and neonateswho delivered menstrually andvaginally at 6 months in our department were rucluded in the experimental group. Comparative analysis of the length of the third stage of labor, the amount of vaginal bleeding within 24 hours postpartum, and the blood glucose immediately after birth was conducted. In addition, total bilirubin level, time of umbilical cord stump shedding, and the incidence of complications three days after birth were compared between the two groups.Results:A total of 617 women that gave birth at full-term vaginally and neonates completed the study. There were 285 cases in the experimental group and 332 cases in the control group. The duration of the third stage of labor was(6.41±1.45) minutes in the experimental group and was( 6.02±1.34) minutes in the control group. There was no significant difference in the duration of the third stage of labor between the two groups(P>0.05); 24-hour postpartum bleeding in the experimental group was less than in the control group, being(287.54±112.45) and(328.42±121.96)ml respectively, the difference was statistically significant( P<0.05); the blood glucose immediately after birth in the experimental group was(4.34±0.84) mmol·L^-1, which was less than that in the control group(3.92±0.78) mmol·L^-1, the difference being statistically significant(P<0.05); the total bilirubin level of newborns in the experimental group on the third day after birth was(6.43±1.44) μmol·L^-1, and(6.42±1.43) μmol·L^-1 in the control group, the difference was not statistically significant(P>0.05); the neonatal umbilical cord stump shedding time in the experimental group was(8.24±1.92) days, which was shorter than that in the control group(9.48±2.28) days, the difference was statistically significant(P<0.05) ); the incidence of neonatal umbilical complications in the experimental group was 2.10%, which was less than that in the control group(6.62%), and the difference was statistically significant(P<0.05).Conclusion:Delayed umbilical cord ligation has a positive significance in reducing the amount of vaginal bleeding in the 24-hour postpartum period, reducing the incidence of postnatal hypoglycemia, accelerating umbilical cord stump shedding, and reducing umbilical complications. However, its relationship with the occurrence risk of neonatal jaundice should be further investigated.

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