Aziz Khalid, Chinnery Heather, Lacaze-Masmonteil Thierry
Department of Pediatrics, University of Alberta, Royal Alexandra Hospital Neonatal Intensive Care Unit, DTC 5027, Royal Alexandra Hospital, 10240 Kingsway, Edmonton, AB T5H 3V9, Canada.
Adv Neonatal Care. 2012 Dec;12(6):371-6. doi: 10.1097/ANC.0b013e3182761246.
To describe the implementation and outcomes of delayed cord clamping (DCC) in preterm babies.
Following staff orientation, a policy of DCC for 45 seconds was instituted for all eligible babies born between 28 and 32 weeks' gestational age, and later to all those younger than 33 weeks.
Of 480 babies, 349 (73%) were eligible for DCC. Of these, 236 (68%) received DCC. Monthly compliance rates to DCC protocol in eligible babies ranged from 18% to 93%. There was no significant difference in demographic measures or rates of delivery room ventilation between eligible babies who did or did not receive DCC. Delayed cord clamping was associated with less hypothermia, higher initial hemoglobin levels, and less necrotizing enterocolitis, with a trend toward lower 1-minute Apgar scores and less blood pressure support.
The DCC protocol is feasible in preterm babies with reinforcement and education. It appears practical, safe, and applicable, and has minimal impact on immediate neonatal transition, with possible early neonatal benefits.
描述早产儿延迟脐带结扎（DCC）的实施情况及结果。
在对工作人员进行培训后，对所有孕龄在28至32周之间出生的符合条件的婴儿实施45秒的DCC政策，随后将该政策应用于所有孕龄小于33周的婴儿。
在480名婴儿中，349名（73%）符合DCC条件。其中，236名（68%）接受了DCC。符合条件的婴儿对DCC方案的月度依从率在18%至93%之间。接受或未接受DCC的符合条件的婴儿在人口统计学指标或产房通气率方面没有显著差异。延迟脐带结扎与体温过低发生率降低、初始血红蛋白水平升高以及坏死性小肠结肠炎发生率降低相关，同时有1分钟阿氏评分较低和血压支持需求较少的趋势。
在加强培训和教育的情况下，DCC方案在早产儿中是可行的。它似乎切实可行、安全且适用，对新生儿即时过渡的影响最小，并可能对新生儿早期有益。
