新生儿破伤风在社区的早期诊断和治疗

Early Diagnosis and Treatment of Neonatal Tetanus in Community Clinics

目的回顾总结新生儿破伤风在基层医院的早期诊断和治疗。方法1993年1月-2003年12月收治的新生儿破伤风患儿，入院后予脐部清洁护理、青霉素、破伤风抗毒素2万单位静脉点滴，第2天再加用半量、安定1．0～1．5mg／kg静脉推注，止惊后，立即插胃管，以后安定每次0．5mg／kg，鲁米那每次5～8mg／kg，肌注，每6h交替应用，以基本不出现抽搐为准，定时鼻饲母乳或奶粉，以维持正氮平衡。结果痊愈8例，好转13例，未愈5例，死亡0例。结论凡有旧法接生史的新生儿，出现不明原因的哭闹、拒乳，社区卫生服务中心的全科医师应想到新生儿破伤风的可能，及早诊断和治疗；

Objective To investigate the early diagnosis and treatment of neonatal tetanus in community clinics. Methods The clinical data of 26 cases of neonatal tetanus in our hospital from January in 1993 to December in 2003 was analyzed retrospectively, the general schemes on neonatal tetanus are as following ： sanitizing and disinfections of umbilicus, infusion of peni cillin and tetanus antitoxin, injection of Diazepam and Luminal to restrain from convulsion, necessary nasal feeding to maintain a positive nitrogen balance. Results Among 26 cases, 8 recovered, 13 ameliorated and 5 quitted. Conclusions In community clinics, it should be diagnosed and treated in time whoever was born in old style delivery and suffering of crying and refusing feeding.