不同分娩方式产妇血清、初乳及胎儿脐血指标研究

游芳 俞黎铭

[摘要] 目的 研究不同分娩方式对产妇血清、初乳及胎儿脐带血各项指标的影响。方法 顺产组和剖宫产组各65例，比较两组产妇血清、初乳及胎儿脐带血指标。 结果 顺产组血清PRL、T3、T4水平均显著高于剖宫产组（P ＜ 0.01）。顺产组产后产初乳时间显著早于剖宫产组（P ＜ 0.01），顺产组初乳中sIgA的水平显著高于剖宫产组（P ＜ 0.05），IGF-1水平显著低于剖宫产组（P ＜ 0.01），两组EGF水平差异无统计学意义（P ＞ 0.05）。两组脐带血PO2差异无统计学意义（P ＞ 0.05），两组pH、PCO2、HCO3-之间差异有统计学意义（P ＜ 0.05）。结论剖宫产对产妇乳汁分泌、初乳生长因子、抗体及新生儿的影响较大。

[关键词] 剖宫产；顺产；血清；初乳；脐血

[中图分类号] R446.1[文献标识码] B[文章编号] 1673-9701（2012）16-0078-02

Study on the indexes of serum, colostrum of maternal and umbilical cord blood by different mode of delivery

YOU Fang1 YU Liming2

1.Department of Gynaecology and Obstetrics，FirstHospital of Wuyi County in Zhejiang Province, Wuyi 321200, China; 2. Department of Gynaecology and Obstetrics, Womens Hospital School of Medicine Zhejiang University,Hangzhou 310006, China

[Abstract] Objective To investigate the indexes of serum, colostrum of maternal and umbilical cord blood by different mode of delivery. MethodsNatural delivery group and cesarean section group were each of 65cases,and the indicators of maternal serum, colostrum and fetal cord blood of two groups were compared. Results The serum levels of PRL, T3, T4,in natural delivery group were significantly higher than the cesarean section group (P ＜ 0.01). The colostrum production and postpartum time of natural delivery group were significantly earlier than the cesarean section group (P ＜ 0.01), the levels of IGF-1, sIgA in colostrum were significantly higher than the cesarean section group (P ＜ 0.05), the levels of EGF between two groups were not significant difference (P ＞ 0.05). PO2 in cord blood between two groups were not statistically significant（P ＞ 0.05）, pH, PCO2, HCO3- between two groups were significant difference （P ＞ 0.05）. Conclusion The cesarean section have greater impact for maternal milk secretion, colostrum growth factors, antibodies and neonatus.

[Key words] Cesarean section; Natural delivery; Serum; Colostrum; Cord blood

母乳是新生儿主要抗体和营养来源，初乳对新生儿的营养价值更为重要。初乳泌乳时间和泌乳量受到神经内分泌系统的调节，易受到多种因素的影响。自然分娩和剖宫产手术迥异的生产方式，对产妇泌乳及胎儿脐带血均产生不同的影响。目前，我国剖宫产率显著升高，有研究表明剖宫产后泌乳时间延迟，初乳量少于自然分娩，可能对新生儿的生长发育造成影响[1]。本研究对顺产和剖宫产产妇血清、初乳成分及脐带血指标进行分析，探讨不同分娩方式对产妇及新生儿的影响。

1资料与方法

1.1一般资料

选择2010年9月~2011年10月在我院分娩的产妇130例，年龄20~37岁，平均（27.48±5.38）岁，孕周36~42周，平均（40.74±0.92）周，体质量49.38~83.85 kg，平均（68.38±3.95）kg，均为单胎，排除心血管疾病、糖尿病、肝肾功能异常、血液病、感染性疾病及免疫系统疾病。按不同生产方式分为顺产组65例和剖宫产组65例，两组年龄、孕周、体质量等临床资料差异无统计学意义（P ＞ 0.05），具有可比性。……