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目的探讨改良方法在新生儿脐带水肿缝合结扎断脐中的可行性及其优势。方法 200例活产新生儿按分娩的先后顺序分为观察组和对照组各100例,对2组新生儿的临床资料进行回顾性分析,比较2组的操作难度、操作时间、脐部出血渗血、感染、正常脱落时间等指标。结果观察组操作时间为(15.0±0.3)s,对照组操作时间为(11.0±0.4)s,2组技术难度、操作时间差异无统计学意义;观察组残脐脱落时间3~6 d 25例,7~10 d 64例,>10 d 11例,对照组残脐脱落时间3~6 d 15例,7~10 d 43例,>10 d 42例,观察组残脐脱落所需时间明显少于对照组,差异有统计学意义(χ~2=24.754,P<0.05);脐部并发症方面,对照组发生脐部出血9例、线结脱落5例、脐炎8例,需二次剪脐5例,肉芽肿及创面不良19例,并发症发生率为46%,观察组无发生脐部出血、线结脱落,脐炎5例,需二次剪脐1例,肉芽肿及创面不良5例,并发症发生率为11%,观察组并发症明显少于对照组,2组比较差异有统计学意义(χ~2=34.149,P<0.05)。结论改良缝扎断脐法处理水肿脐带可防止断脐后线结滑脱,防止脐部感染,杜绝脐部出血,加速脐部残端干燥。
Objective To explore the feasibility and advantage of the improved method in sutured umbilical cord in neonatal umbilical cord edema. Methods 200 cases of live birth newborn were divided into observation group and control group according to the order of delivery. The clinical data of two groups were retrospectively analyzed. The operation difficulty, operation time, umbilical hemorrhage Blood, infection, normal off time and other indicators. Results The operation time was (15.0 ± 0.3) s in the observation group and (11.0 ± 0.4) s in the control group. There was no significant difference in the technical difficulty and operation time in the observation group. 25 cases , 7 to 10 days in 64 cases and> 10 days in 11 cases. In the control group, there were 15 cases with remnant umbilical detachment time of 3 to 6 days, 43 cases in 7 to 10 days and 42 cases of> 10 days. In the control group, the difference was statistically significant (χ ~ 2 = 24.754, P <0.05); umbilical complications, the control group occurred umbilical hemorrhage in 9 cases, 5 cases of line off, 8 cases of omphalitis, There were 5 cases of umbilical cord incision, 19 cases of granuloma and wound defect, and the complication rate was 46%. There were no umbilical hemorrhage, cord slippage and omphalitis in 5 cases in the observation group. 5 cases were poor, the complication rate was 11%. The complication in the observation group was less than that in the control group. The difference between the two groups was statistically significant (χ ~ 2 = 34.149, P <0.05). Conclusion Improved suture method of umbilicus treatment of edema umbilical cord can prevent slippage after disconnection of the umbilicus to prevent umbilical infection, to prevent bleeding umbilical cord, umbilical stump to speed up the drying.