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目的探讨显性脐带脱垂与围生儿死亡的关系、易发因素、处理方法及预防措施。方法回顾性分析41例显性脐带脱垂的临床资料。结果剖宫产组新生儿1 min Apgar评分≤7分者占52.17%(12/23),显著低于阴道分娩84.38%(27/32)(P<0.01);剖宫产组新生儿存活率91.30%(21/23),高于阴道分娩组56.25%(18/32),差异有统计学意义(P<0.01)。诊断至胎儿娩出时间间隔(diagnosis delivery interval,DDI)>30 min的新生儿1 min Apgar评分≤7分者占82.76%,显著高于DDI≤30 min患者58.33%(P<0.05),且前者新生儿病死率为44.83%,显著高于后者4.17%(P<0.01)。结论显性脐带脱垂与围生儿病死率有密切的关系,围生儿生存和窒息情况与分娩方式、诊断至分娩时间有密切关联。
Objective To explore the relationship between dominant umbilical cord prolapse and perinatal mortality, the predisposing factors, treatment methods and preventive measures. Methods The clinical data of 41 cases of dominant umbilical cord prolapse were retrospectively analyzed. Results Neonatal cesarean section group 1 minute Apgar score ≤ 7 points accounted for 52.17% (12/23), significantly lower than vaginal delivery 84.38% (27/32) (P <0.01); cesarean section neonatal survival rate 91.30% (21/23), higher than vaginal delivery group 56.25% (18/32), the difference was statistically significant (P <0.01). Neonates diagnosed to have a diagnosis delivery interval (DDI)> 30 min at 1 min were 82.76% with Apgar score less than 7, significantly higher than those with DDI ≤ 30 min (58.33%, P <0.05) The case fatality rate was 44.83%, significantly higher than the latter 4.17% (P <0.01). Conclusions The dominant umbilical cord prolapse has a close relationship with perinatal morbidity. The perinatal survival and asphyxia are closely related to the mode of delivery and the diagnosis to delivery time.