新生儿脐部暴露时机选择的临床研究

目的 探讨新生儿脐部暴露的最佳时期.方法 选取2012年12月～2013年11月在本院自然分娩的足月新生儿2000例为研究对象,随机分为A、B、C、D4组,每组500例,A、B、C、D组分别在断脐即刻、12 h、24 h、48 h暴露脐部残端.观察4组新生儿10 d内脐部出血发生率、脐部感染发生率、脐带残端脱落时间、脐部愈合时间,住院期间由专人观察并记录,出院后由同一人进行跟踪随访.结果 A组10 d内脐部出血发生率显著低于B、C、D组（P＜0.05）;A、B组脐部感染发生率为5.0％、6.8％,显著低于C、D组（P＜0.05）.A组脐带残端脱落时间及脐部愈合时间均短于B、C、D组（P＜0.05）.结论 新生儿断脐即刻是暴露脐部残端的最佳时期,可提高新生儿脐部护理质量,促使脐部残端愈合,降低新生儿脐部感染及死亡率.

Clinical research of newborn umbilical exposure timing

Objective To explore the best period of neonatal umbilical exposure. Methods 2000 cases of newborns through natural childbirth in our hospital from December 2012 to November 2013 were selected for the study, and were randomly divided into group A, B, C, D, 500 cases in each group, in group A, B, C, D, the umbilical exposure time was omphalotomy immediately, 12 hours, 24 hours, 48 hours after omphalotomy. The incidence of umbilical bleeding within 10 days, umbilical infection incidence, umbilical stub loss time, umbilical healing time and hospital stay was observed and recorded in hospital, and followed up by the same person after discharge. Results The incidence of umbilical bleeding of group A within 10 days was significantly lower than that of group B, C, D （P〈0.05）; the umbilical infection rate of group A and B was 5.0% and 6.8%, which was significantly lower than that of group C, D respectively （P〈0.05）. The off time, and the umbilical cord stump healing time of group A was less than that of group B, C, D （P〈0.05）. Conclusion The best umbilical exposure time of newborn is umbilical stump immediately, can improve the quality of neonatal umbilical care, prompte the umbilical stump healing, reduce neonatal umbilical infection and mortality.