新生儿脐部感染细菌定植的临床分析研究

Clinical study of bacterial colonization and umbilical infections in neonates

目的对新生儿脐部感染细菌定植进行分析研究,以减少新生儿脐部感染率。方法选取2012年3月-2013年3月接收的225例新生儿作为研究对象,随机将其分为干预组114例和对照组111例;对照组采用常规的脐部护理,干预组则采用脐部干预措施,对比两组新生儿脐部细菌感染率及细菌定植率,并探讨新生儿脐部感染的相关因素。结果 225例新生儿发生脐部感染45例,感染率为20.0%;观察组感染率为10.5%,对照组为29.7%,两组新生儿脐部感染率比较差异有统计学意义(P<0.05);干预组和对照组的细菌定植率分别为95.6%和92.8%,两组比较差异无统计学意义;而两组新生儿病原菌的感染率只有大肠埃希菌的感染率差异有统计学意义(P<0.05),其他病原菌的感染率差异无统计学意义;脐部感染的原因以脐端消毒不严所致的感染率最高,为55.0%;其次是脐带结扎位置及脐带修剪不净,感染率分别为22.6%和22.2%。结论新生儿脐部是细菌定植的好发部位,因此需要做好新生儿的脐部护理,减少脐部感染的发生。

OBJECTIVE To study the bacterial colonization in neonates with umbilical infections so as to reduce the incidence of umbilical infections in the neonates .METHODS A total of 225 neonates who were enrolled in the hos‐pital from Mar 2012 to Mar 2013 were recruited as the study objects and randomly divided into the intervention group with 114 cases and the control group with 111 cases .The control group was treated with conventional um‐bilical nursing ,while the intervention group was given the umbilical interventions .The incidence of umbilical infec‐tions and the rate of bacterial colonization in neonates were compared between the two groups ,and the related fac‐tors for the umbilical infections in the neonates were explored .RESULTS The umbilical infections occurred in 45 of 225 neonates with the infection rate of 20 .0% ;the infection rate was 10 .5% in the observation group ,29 .7% in the control group ,and there was significant difference in the incidence of umbilical infections between the two groups of neonates （P〈0 .05） .The rate of bacterial colonization was 95 .6% in the intervention group ,92 .8% in the control group ,and there was no significant difference between the two groups;however ,there was only sig‐nificant difference in the incidence of Escherichia coli infections between the two groups of neonates （P〈0 .05） , there was no significant difference in the incidence of infections caused by other species of pathogens .The incidence of umbilical infections due to the incomplete disinfection of umbilical end was the highest （55 .0% ） ,followed by the position of umbilical cord ligation （22 .6% ） and the incomplete trim of umbilical cord （22 .2% ） .CONCLUSION The umbilical region of the neonates is the predilection site for bacterial colonization ,therefore ,it is necessary to take good umbilical care for the neonates so as to reduce the incidence of umbilical infections .