改良缝扎断脐法处理水肿脐带的效果观察  

Effect of modified sutureligation method for infants with umbilical cord edema

作　　者：邓惠玲[1] 邓惠转 赵凤乔 邓丽娟[1] 

机构地区：[1]广东医学院附属中山医院产科,广东中山528415 [2]中山市东凤人民医院妇产科,广东中山528415

出　　处：《中华全科医学》2016年第3期426-427,461,共3页Chinese Journal of General Practice

基　　金：广东省中山市医学科研基金项目(2013A120)

摘　　要：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 investigate the feasibility and advantages of modified suture method for cutting edematous umbilical cord. Methods Total 200 cases of live births according to their sequence in the delivery were divided into observation group and control group with 100 cases in each group. The improved suture ligation method was used in the observation group. The clinical data of two cases were analyzed retrospectively. The difficult of operation,operating time,umbilicus hemorrhage,infection,and time for umbilical cord stump to fall off were compared between the two groups. Results The operating 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 different about the technical difficulty and operating time between two groups; the time for umbilical cord stump to fall off in the observation group was 3- 6 d in 25 cases,7- 10 d in 64 cases,〉 10 d in 11 cases,and in the control group was 3- 6 d in 15 cases,7- 10 d in 43 cases, 〉10 d in 42 cases,the time of the observation group was significantly less than the control group,the difference was statistically significant（ Chi-square value 24. 754,P〈0. 05）. The rate of complications in the control group was 46%,including 9 cases of umbilical bleeding,5 cases of knot-off,8 cases of omphalitis,5 cases who needed to cut the umbilical again,19 cases of granulomas and poor wound; while in the observation group was 11%,including 5 cases of omphalitis,1 case who needed to cut the umbilical again,5 cases of granulomas and poor wound,without umbilical bleeding and knot-off. The incidence of complications in the observation group was significantly less than that in the control group,and the difference was statistically significant（ chi-square value of 34. 149,P〈0. 05）.Conclusion Umbilical cord edema; Newborn; Improvement; Suture ligation for bleeding control; Prevention of bleeding

关 键 词：脐带水肿 新生儿 改良 缝合结扎 预防出血 

分 类 号：R719[医药卫生—妇产科学]