新生儿脐带护理方法的比较分析

目的探讨新生儿脐带护理的方法。方法选择天津市红桥医院出生的健康足月新生儿200例,2017年9月-2018年8月出生的100例为观察组,2016年9月-2017年8月出生的100例为对照组。两组断脐后消毒,纱布包扎24 h,观察组脐带消毒干燥暴露,对照组脐带消毒后采用护脐带包裹。比较观察两组新生儿脐带残端脱落时间、脐部完全愈合时间、脐部出血、感染情况。结果观察组脐带脱落,完全愈合时间均少于对照组,脐部出血、感染发生率均低于对照组,差异均有统计学意义(P0.05)。结论新生儿出生后,脐带一定要采取正确的护理方法,脐带护理在预防脐带感染的同时,可确保新生儿的生长发育。医务人员应具体问题具体分析,严格选择脐带护理的方法,保持脐部清洁,对预防新生儿脐带感染有重要的临床意义。     

新生儿脐带残端修剪预防脐部感染的临床报告

目的　分析新生儿脐带残端的早期修剪时间与修剪效果之间的关系 ,判断脐带修剪在预防、治疗新生儿脐部感染中的临床意义。方法　将 90 0例健康新生儿 ,随机分为 3组 ,每组 30 0例 ,分别于出生后 2 4- 48小时内 ;48- 72小时内 ;72 - 96小时内。以无菌器械 ,在常规消毒后 ,提起脐带残端 ,于脐根上方、脐带结扎处的下方 ,修剪掉脐带残端 ,使脐根部暴露、易于干燥清洁。并以修剪时有无出血及分泌物情况为观察指标 ,比较分析 3组病历之间的差异。结果　以 48- 72小时内修剪组出血少、局部清洁 ,分泌物渗出少。是修剪脐带残端的适宜时间。结论　新生儿脐带残端的早期修剪是一种改变传统脐部护理的先进方法     

新生儿脐带暴露法对脐部感染和脐带残端脱落的影响

目的 比较应用WHO倡导的脐带暴露法与传统的脐带包扎法对预防新生儿脐部感染和脐带残端脱落时间长短的影响.方法 选择2012年10月至11月住院分娩的356例新生儿,随机分为脐带暴露法组与脐带包扎法组,两组脐带结扎方法相同,脐带暴露法组断脐后在产房开始即暴露脐带,日常护理用清水清洁脐部,不用任何消毒液;脐带包扎法组断脐后使用脐带卷包扎,日常护理仍然使用75％酒精消毒脐部并每日包扎.比较分析两组新生儿脐带残端脱落时间、脱落率、脐部分泌物及脐炎发生率情况.结果 脐带暴露法组脐带残端脱落时间多集中在6～7天,而脐带包扎法组多在7天以上,两组脱落率分别有显著差异（P＜0.01）;脐带暴露法组脐部分泌物和轻度脐炎发生率明显低于脐带包扎法组（P＜0.01和P＜0.05）.结论 采用脐带暴露法可明显缩短脐带残端脱落时间,并能降低脐部感染率,是一种安全有效的新生儿脐部护理方法.     

两种新生儿脐部护理方法的观察比较

目的 比较自然干燥法与消毒包扎法在新生儿脐部护理中的应用效果.方法 将100例足月新生儿随机分为观察组（n =50,自然干燥法,出生24 h后不予包扎,暴露并保持干燥）和对照组（n=50,消毒包扎法,每天沐浴后使用75％酒精消毒,愈脐带包扎）.观察两组新生儿脐带脱落时间、脐炎的发生率,并调查其父母的满意度.结果 两组新生儿均无重度脐炎发生,且脐带的脱落时间、脐炎发生率差异均无统计学意义（P均＞0.05）;观察组父母的满意度高于对照组（P＜0.05）.结论 自然干燥法脐带护理操作方便,既不增加脐部感染的风险,又节省了医疗费用,减轻了护理的工作量,提高了父母的满意度,值得临床推广.     

自然干燥法与脐部包扎法对新生儿脐部愈合的效果研究

目的:探讨自然干燥法与脐部包扎法对新生儿脐部愈合效果的影响.方法:选取682例新生儿设为对照组,采取脐部包扎法予以脐部护理；选取778例新生儿设为试验组,采取自然干燥法予以脐部护理.比较两组新生儿脐部出血、感染的发生率以及脐带残端脱落时间.结果:对照组与试验组出血、脐炎的发生率以及脐残端脱落时间比较,差异均无统计学意义(P＞0.05).但试验组轻度脐炎发生率高于对照组,重度脐炎发生率低于对照组,差异具有统计学意义(P＜0.05).结论:自然干燥法对新生儿脐部愈合是安全的,且更方便和更经济,对新生儿脐部护理具有一定的指导意义.     

自然干燥法与消毒包扎法在新生儿脐部护理中的应用比较

目的比较自然干燥法与消毒包扎法在新生儿脐部护理中的应用效果。方法将100例足月新生儿随机分为观察组(n=50,自然干燥法,出生24 h后不予包扎,暴露并保持干燥)和对照组(n=50,消毒包扎法,每天沐浴后使用75%酒精消毒,愈脐带包扎)。观察两组新生儿脐带脱落时间、脐炎的发生率,并调查其父母的满意度。结果两组新生儿均无重度脐炎发生,且脐带的脱落时间、脐炎发生率差异均无统计学意义(P均>0.05);观察组父母的满意度高于对照组(P<0.05)。结论自然干燥法脐带护理操作方便,既不增加脐部感染的风险,又节省了医疗费用,减轻了护理的工作量,提高了父母的满意度,值得临床推广。     

延迟断脐结合自然干燥法在新生儿脐部护理中的应用

目的研究探讨新生儿脐部护理的最佳方法。方法将我院出生的210例足月顺娩新生儿随机分为三组,结扎脐带方法均采用延迟断脐法。试验组70例采用自然干燥法,在脐带未脱落前不涂抹任何消毒剂,不包扎,保持清洁干燥。对照组两组,各70例,对照1组每日用75%酒精消毒,用愈脐胎毒清包扎。对照2组每日用爱尔碘消毒,用愈脐胎毒清包扎。观察记录各组新生儿脐带脱落时间、脐周并发症。结果使用自然干燥法护理新生儿脐带,脐带自然脱落时间最短,与对照组两组比较差异均具有统计学意义(P<0.05)。三组中均无重度脐炎发生。轻度脐炎发生率差异无统计学意义。结论自然干燥法护理新生儿脐带能促使脐带残端自然脱落,同时也减少了不必要的经费和操作,是一种安全、有效的新生儿脐部护理方法,值得临床推广。     

脐部清洁干燥法在新生儿脐部护理中的应用评价

目的:探讨脐部清洁干燥法在新生儿脐部护理中的应用效果。方法:将于我院分娩出的足月新生儿中随机抽出86例,将其平均分成观察组和对照组。其中,对照组以常规护理模式,观察组采取脐部清洁干燥法,比较两组新生儿的护理效果。结果:观察组并发症发生率较对照组低(16.28%37.21%);观察组脐带残端脱落时间低于对照组对应值,且P0.05。结论:对新生儿脐部护理中采用脐部清洁干燥法进行干预,有效缩短其脐带残端脱落时间的同时减少新生儿并发症发生次数,安全性较高,值得推广。     

清洁干燥法在新生儿脐带护理中的应用分析

目的:讨论清洁干燥法在新生儿脐带护理中的应用效果.方法:选取2013年4月—2016年4月在我院出生的正常足月新生儿168例,将其随机分为观察组和对照组,每组各84例,两组均采用低位脐带结扎法,对照组采用每天5%聚维酮碘溶液消毒,并用无菌纱布脐带卷覆盖包扎的常规脐带护理方式,观察组采取清洁干燥法护理,对两组新生儿脐带脱落时间、脐部愈合时间以及并发症的发生情况进行比较.结果:观察组新生儿脐带脱落时间为(7.93±1.33)d、脐部愈合时间为(11.73±1.62)d,明显短于对照组的(9.65±2.15)d以及(13.21±2.34)d,且(P<0.05);观察组新生儿并发症的总发生率为1.19%,明显低于对照组的8.33%(P<0.05).结论:清洁干燥护理法可有效缩短脐带脱落脱落及脐部愈合时间,减少新生儿脐部并发症的发生.     

新生儿脐带护理不同方法效果研究

目的:探讨新生儿不同脐带护理方法的效果,得出其临床应用价值.方法:选取2016年1月至2016年12月每个月30例共计360例新生儿作为研究对象,将360例新生儿分为实验组和常规组,每组180例,新生儿出生后2分钟之内用细橡胶管在脐带根部0.1cm结扎,并在0.5cm处剪断脐带.常规组新生儿在首次沐浴后用75％乙醇旋转擦拭脐带断面和脐带轮状周围,并更换无菌护脐帖,以后每次沐浴都用同上方法消毒并更换无菌帖.实验组患者的消毒方法同常规组,但是不用护脐贴包扎,完全暴露脐带部位,以后每次沐浴只消毒直至自然脱落.观察两组新生儿脐带护理效果、脐部感染以及脐带平均脱落时间.结果:观察组新生儿脐带自然脱落的时间为(4.2±2.5)d,明显短于对照组的(6.8±2.3)d,组间差异明显,有统计学意义(p＜0.05).实验组发生脐部感染1例,脐部感染概率为0.56％;对照组发生脐部感染18例,脐部感染概率为10％,组间差异明显,有统计学意义(p＜0.05).结论:针对新生儿采用脐带完全暴露法能够有效保证脐带部位的干燥和透气,促进脐带结痂、干枯、硬化,加快脐带的自然脱落,进而将其脐带炎症感染.     

新生儿脐带二次结扎加暴露法的临床应用观察

目的探讨新生儿脐带二次结扎加暴露对新生儿脐带的影响及效果。方法将广元市第二人民医院730例新生儿随机分为观察组和对照组,对照组采取传统的气门芯结扎法,观察组在新生儿出生后24~36 h行脐带二次结扎加暴露,观察新生儿脐带脱落时间、脐部感染发生率等指标。结果观察组新生儿脐带脱落时间短于对照组,脐部感染发生率少于对照组(P0.05)。结论新生儿脐带二次结扎加暴露法,能有效缩短脐带脱落时间,减少脐部感染的发生。     

不同断脐长度联合脐带自然干燥脱落在降低新生儿脐炎中的应用研究

目的 分析不同断脐长度联合脐带自然干燥脱落在降低新生儿脐炎中的应用效果.方法 选取2019年7月—2020年6月本院出生的104例新生儿作为研究对象,根据等分方法 随机分为研究组和对照组,每组52例.对新生儿脐带脱落时间、脐带残端创面干燥良好情况及脐周并发症进行观察与分析.结果 研究组中新生儿的脐带脱落时间为(6.88...     

康脐宝与传统新生儿脐部护理在新生儿脐部护理的应用效果评价

目的对传统新生儿脐部护理和康脐宝在新生儿脐部护理应用的效果进行评价。方法将300例新生儿按出生先后常规断脐后随机分为两组。每组150例,实验组在新生儿每天沐浴后,使用康脐宝进行消毒,对照组在新生儿每天沐浴后常规用75%酒精消毒脐部后敷纱块覆盖脐部。结果与对照组相比实验组脐部感染发生率显著降低(P﹤0.05),脐带脱落时间显著缩短(P﹤0.05),脐周皮肤破损率显著减少(P﹤0.05)。结论康脐宝在新生儿脐部护理中可明显减少新生儿的脐部感染率,加快脐带脱落的时间,操作简单方便,适合作为脐部消毒常规用药。     

75％酒精与0．5％碘伏用于鼻内窥镜手术后感染状态的研究

目的探讨75％酒精及0．5％碘伏用于鼻窦内窥镜手术面部皮肤消毒效果及对鼻腔术后感染的影响。方法将1850例经鼻内窥镜下行鼻窦手术患者,采用随机分为75％酒精消毒为实验组（A）和0．5％碘伏消毒对照组（B）,每组各925例,观察两组皮肤存茵、术后鼻腔感染情况。结果两种消毒方法皮肤除茵率A组高于B组,差异有统计学意义;发生手术部位感染A组为1例,B组为3例,均为轻度感染,经消炎换药后均痊愈出院。结论两种消毒液均安全可靠．75％酒精可用于鼻内镜鼻窦手术面部皮肤消毒,替代传统的碘伏消毒方法。     

辐照猪皮在儿童深Ⅱ度烧伤治疗中的应用研究

目的：总结分析辐照猪皮在儿童深Ⅱ度烧伤治疗中的应用效果。方法：选择2009年1月-2012年1月本院收治的60例年龄〈12岁的深Ⅱ度烧伤儿童患者为研究对象,按随机数字表法随机分为观察组和对照组,每组各30例。观察组儿童患者创面清创后给予辐照猪皮覆盖包扎,对照组儿童患者创面清创后给予聚维酮碘纱包扎,比较两组患者的创面愈合时间、疼痛情况等。结果：观察组换药次数（1.1±0.1）次、愈合时间（14.2±2.1）d明显少于对照组,差异具有统计学意义（P〈0.05）;观察组止疼比例96.67%明显高于对照组的60.00%,感染率3.33%明显低于对照组的20.00%,差异均具有统计学意义（P〈0.05）。结论：在深Ⅱ度烧伤儿童患者治疗中应用辐照猪皮能减轻儿童痛苦,缩短疗程,且疗效可靠,创面愈合较好。     

腹腔镜手术前脐部不同备皮法临床观察

目的探讨腹腔镜手术前脐部两种备皮法的临床效果。方法选择选择2010年1月-2012年1月住我院肝胆外科患慢性胆囊炎并胆囊结石病人200例(病人均需进行择期电视腹腔镜胆囊切除术),按入院顺序分别随机分为观察组和对照组各100例。观察组于术前1天用肥皂液清洗脐部,脐孔内污垢较多者用棉签蘸肥皂液反复清洗,直至污垢完全清除为止,对照组按常规用松节油去除脐部污垢。两组均于术前用棉签蘸2.5%碘酊消毒脐孔及周围皮肤(范围以脐孔为中心,直径8cm),2min后用75%酒精脱碘,待酒精干后用盐水棉签在脐孔作环形涂擦,反复2次,然后将棉签放入无菌试管中,送细菌室接种在无菌琼脂培养皿中,培养24h观察结果。结果两组术前脐部皮肤细菌培养结果显示两组间差异无显著性(X2=-0.68,P>0.05);两组病例切口愈合情况比较,观察组与对照组在切口愈合方面差异无显著性(P>0.05)。结论在认真清洁手术野皮肤的前提下,采用传统的松节油脐部除污垢法和试行的肥皂液脐部除污垢法对手术野皮肤的无菌准备及切口愈合并无差异,且肥皂液取用方便,无异味,对皮肤无任何刺激性,克服了松节油对皮肤刺激引起的过敏反应,从而保证了手术前皮肤准备的顺利完成,值得临床推广应用。     

Double-blind comparative study on the care of the neonatal umbilical cord using 80% ethanol with or without chlorhexidine

We conducted a double-blind comparative study on the effectiveness of 80% ethanol (EtOH), with or without chlorhexidine (CHD), in the prevention of neonatal umbilical colonization by Staphylococcus aureus, the most frequently isolated pathogen on the neonatal umbilicus in the early period. A total of 100 neonates born at the National Tokyo Medical Centre from March to May 2000 and nursed at a maternity ward were enrolled. Forty-eight were randomly allocated to the group for whom umbilical cord disinfection was performed using 80% EtOH containing 0.5% CHD (CHD group) and 52 to disinfection with 80% EtOH alone (EtOH group). The mothers of the neonates and the nursing staff were unaware as to which disinfectant was being used. Disinfection of the umbilicus and the surrounding area was done immediately after birth and twice daily thereafter, after bathing and in the evening, throughout the hospitalization period. Specimens for bacterial culture were taken from the umbilical cord and surrounding skin on day 4 or 5 after birth. As a disinfectant susceptibility test, we checked the minimum killing concentration (MKC) of CHD and EtOH. There was no statistically significant difference between the two groups with respect to sex, gestation period, birthweight, APGAR score or delivery method. In the CHD group, S. aureus was isolated from 25% of the patients, while it was isolated from 57.7% in the EtOH group (P<0.001). In the CHD group, 50% of the S. aureus strains were MRSA, compared with 73.3% in the EtOH group (non-significant). All the S. aureus strains were killed by the combination of both CHD and EtOH at the concentrations used. In terms of the MKC90, there was no significant difference between the CHD group and the EtOH group. For the daily care of the neonatal umbilicus, disinfection using 80% EtOH containing CHD was found to be more effective than that using 80% EtOH alone in preventing colonization by S. aureus.     

新生儿二次剪脐术后预防脐出血与感染

目的:探讨气门芯结扎脐带二次剪脐术的最佳时间和方法,减少新生儿二次剪脐术后出血和脐部感染,缩短脐部愈合时间。方法:经筛选出的新生儿240例行气门芯结扎脐带后,随机分成4组:明胶海绵组(A组)、云南白药组(B组)、残端未包扎组(C组)三组剪脐时间均为出生24h,脐带干枯组(D组)二次剪脐时间在出生48～72h。结果:①新生儿剪脐24h和7天后脐部出血情况分别为:C组出血例数明显增加,A、B、D组与C组比较,χ2=32.64、P<0.001,χ2=65.17、P<0.001。②剪脐7天后脐部分泌物情况:B组脐部分泌物增加,脐部潮湿。A、C、D组与B组比较,χ2=32.99,P<0.001。③剪脐后脐部愈合时间比较:D组愈合时间最短,与其它3组组间比较,P<0.001。结论:根据脐带的干燥程度决定剪脐时间,再配合应用明胶海绵压迫包扎,将大大减少脐带出血、感染的发生率,缩短脐部愈合时间。     

Alcohol or traditional methods versus natural drying for newborn's cord care

This is a quasi-experimental study that aimed to compare the use of alcohol and traditional methods for newborn's cord care with a no-treatment approach, natural drying. The study also aimed to identify the factors associated with the occurrence of cord infection and time of cord separation. A convenient sample of 70 women with vaginal delivery, full-term and healthy babies was selected from postpartum departments of two university hospitals in Alexandria and Minia. A specially designed interview schedule was developed and utilized to collect data. Swabs were taken from the newborns' umbilical stumps on zero and 3rd day of birth to detect bacterial colonization. Follow-up was carried-out at home to assess methods used for cord care, babies' hygiene, cord infection and time of cord separation. The study revealed that traditional methods of cord care were used by women with higher mean age (30.8 +/- 7.8 years), from Minia (100%) or rural areas (71.4%), while alcohol and natural drying were used by women with lower mean age (27.7 +/- 4.8 and 24.8 +/- 6.5 years) respectively, from Alexandria (76% and 100%) respectively or urban areas (56% and 64.7%) respectively. Alcohol was used for male babies (76%), while traditional methods and natural drying were used for female babies (71.4% & 64.7%) respectively. Incidence of cord infection was significantly lower among natural drying group (35.3%), and no signs of systemic infection were observed among them. Rate of increase of bacterial colonization (from 0-3rd day of birth) was significantly higher in alcohol group (44%). It was relatively similar with presence or absence of cord infection (33.3 & 32.1) respectively. Mean time of cord separation was longer among alcohol group (6.4 +/- 2.4 days), as compared with natural drying group (4.7 +/- 1.9 days) and traditional methods group (3.4 +/- 0.7 days). Bathing baby while cord was attached was carried-out by all women of alcohol and natural drying groups, compared to only 28.6% of traditional methods group. Breast-feeding was significantly related to less incidence of cord infection (P= 0.008) and shorter time of cord separation (P= 0.002). Incidence of cord infection was significantly related to using cloth diaper (P= 0.015), using dry method for skin care (X(2) 2= 7.2917), giving tub bath (X(1)2 = 4.1788) and delaying the bath to the 7th day of birth (P= 0.050). Time of cord separation was significantly shorter with closed cord dressing (X(2)2= 20.4028), in Minia, during spring, among male babies (X(2)2= 15.0352), and in rural areas (X(2)2 = 9.7608). It was significantly longer with bathing the baby while cord was attached (X(2)2 = 27.9354), giving 2-3 baths/week or delaying the bath to the 7th day of birth (P= 0.049) and with using cloth diaper (P= 0.0467). So, moving from an intervention to a non- intervention, particularly in a healthy population should be applied to the healthy naturalistic approach to care advocated in nursing. Also, only through continuing efforts done to examine our assumptions about historic health care routines, will we be able to demonstrate evidence-based practice and to advance nursing care.