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。

A Study of umbilical cord recutting in preventing umbilical bleeding or infection in neonates

Objective:To investigate the best time and way of umbilical cord recutting of neonates by robbery ring ligation in preventing umbilical bleeding or infection and reducing the healing time of umbilical endings.Methods:240 neonates were randomly assigned to four groups after umbilical cord cutting of neonates by rubbery rings ligation.Umbilical endings neonates in group A and B were wrapped by gel sponge and yunnan baiyao,while were exposed in air after umbilical cutting in group C.Umbilical cutting were finished in 24 hours in neonates in all above groups.Umbilical cutting time in neonates of groups D depended on the moisture of umbilical endings in 48 to 72 hours after birth.Results:①Umbilical endings bleeding in unwrapped group(group C)was higher than wrapped group(A.B,D)at the.time of 24 hours and 7 days after umbilicalcutting,χ2=32.64,P<0.001;χ2=65.17,P<0.001;② Secretions of umbilical endings in group B was increased than in group A,C and D,χ2=32.99,P<0.001.③Healing time of umbilical endings in group D was the shorterthan in 4 groups,P<0.001.Conclusion:Umbilical cutting time depending on the moisture of umbilical endings and wrapped by gel sponge can decrease the bleeding and infection of umbilical endings and promote the healing.