Lin Ling, Peng Hao
Department of Pediatrics, Suining Central Hospital, Suining, Sichuan 629000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Apr;23(4):332-337. doi: 10.7499/j.issn.1008-8830.2011158.
To compare the effect of delayed cord clamping (DCC) versus umbilical cord milking (UCM) on cerebral blood flow in preterm infants.
This was a single-center, prospective, double-blind, randomized controlled trial. A total of 46 preterm infants, with a gestational age of 30-33 weeks, who were born in Suining Central Hospital from November 2, 2018 to November 15, 2019 were enrolled and randomly divided into DCC group and UCM group, with 23 infants in each group. The primary outcome indexes included cerebral hemodynamic parameters[peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI)] measured by ultrasound within 0.5-1 hour, (24±1) hours, (48±1) hours, and (72±1) hours after birth. Secondary outcome indexes included hematocrit, hemoglobin, red blood cell count, and serum total bilirubin levels on the first day after birth and the incidence rate of intraventricular hemorrhage during hospitalization.
A total of 21 preterm infants in the DCC group and 23 in the UCM group were included in the statistical analysis. There was no significant difference in PSV, EDV, and RI between the two groups at all time points after birth ( > 0.05). There was also no significant difference between the two groups in the hematocrit, hemoglobin, red blood cell count and total bilirubin levels on the first day after birth, and the incidence rate of intraventricular hemorrhage during hospitalization ( > 0.05).
DCC and UCM have a similar effect on cerebral hemodynamics in preterm infants with a gestational age of 30-33 weeks.
比较延迟脐带结扎(DCC)与脐带挤血(UCM)对早产儿脑血流的影响。
这是一项单中心、前瞻性、双盲、随机对照试验。纳入2018年11月2日至2019年11月15日在遂宁市中心医院出生的46例孕周为30 - 33周的早产儿,随机分为DCC组和UCM组,每组23例。主要结局指标包括出生后0.5 - 1小时、(24±1)小时、(48±1)小时和(72±1)小时通过超声测量的脑血流动力学参数[收缩期峰值流速(PSV)、舒张末期流速(EDV)和阻力指数(RI)]。次要结局指标包括出生后第一天的血细胞比容、血红蛋白、红细胞计数和血清总胆红素水平以及住院期间脑室内出血的发生率。
DCC组共21例早产儿、UCM组共23例早产儿纳入统计分析。两组出生后各时间点的PSV、EDV和RI比较,差异均无统计学意义(>0.05)。两组出生后第一天的血细胞比容、血红蛋白、红细胞计数和总胆红素水平以及住院期间脑室内出血的发生率比较,差异也均无统计学意义(>0.05)。
DCC和UCM对孕周为30 - 33周的早产儿脑血流动力学的影响相似。