Panyavudhikrai Sopapan, Danchaivijitr Somwang, Vantanasiri Chanchai, Trakulsomboon Suwanna, Kolatat Thrathip, Dhiraputra Chertsak, Poomsuwan Varaporn, Srihapol Nitaya
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2002 Feb;85(2):229-34.
Omphalitis may cause serious complications and contribute to neonatal morbidity and mortality. From January 1997 to August 1998, the incidence of omphalitis in the Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital had been increased from 0.9 to 17.4 per 1,000 live births. A prospective randomized trial using antiseptic applied directly to the umbilical stump was conducted aiming to reduce an epidemic outbreak of omphalitis in the newborn nursery.
To determine which antiseptic is appropriate for preventing omphalitis in the newborn infants.
Newborn infants delivered in the Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital were randomized into group A (Triple dye) or group B (70% Alcohol). The infant with omphalitis was assessed by a pediatrician or a neonatology fellow. At home, the same antiseptic will be continually applied to the umbilical stump daily until a few days after cord detachment. Relative risk was calculated and statistical significance was tested by Chi-square test.
Four hundred and twenty-seven infants were enrolled. Birth weight, gestational age and gender of the infants in both groups were not different. There were no known maternal risk factors for omphalitis. Omphalitis was observed in 9/213 (4.2%) infants in group A and 23/214 (10.7%) infants in group B. The relative incidence rate between each group was statistically significant (p<0.01). Triple dye group was 60 per cent less likely to develop omphalitis compared to 70 per cent Alcohol group (RR 0.39, 95% CI: 0.19-0.83). The mean duration for cord detachment were 13.6 and 11.5 days in group A and group B, respectively.
During an epidemic outbreak of omphalitis, Triple dye was the most appropriate and effective antiseptic to prevent omphalitis but could delay cord separation.
脐炎可能导致严重并发症，并增加新生儿发病率和死亡率。1997年1月至1998年8月期间，诗里拉吉医院医学院妇产科的脐炎发病率从每1000例活产0.9例增至17.4例。开展了一项前瞻性随机试验，直接将防腐剂应用于脐带残端，旨在减少新生儿病房脐炎的暴发流行。
确定哪种防腐剂适合预防新生儿脐炎。
诗里拉吉医院医学院妇产科分娩的新生儿被随机分为A组（三联染料）或B组（70%酒精）。由儿科医生或新生儿科医生评估患有脐炎的婴儿。在家中，每天持续将相同的防腐剂应用于脐带残端，直至脐带脱落几天后。计算相对风险，并通过卡方检验检验统计学显著性。
共纳入427名婴儿。两组婴儿的出生体重、孕周和性别无差异。不存在已知的母亲脐炎风险因素。A组213名婴儿中有9名（4.2%）发生脐炎，B组214名婴儿中有23名（10.7%）发生脐炎。两组之间的相对发病率具有统计学显著性（p<0.01）。与70%酒精组相比，三联染料组发生脐炎的可能性低60%（RR 0.39，95%CI：0.19 - 0.83）。A组和B组脐带脱落的平均持续时间分别为13.6天和11.5天。
在脐炎暴发流行期间，三联染料是预防脐炎最合适且有效的防腐剂，但可能会延迟脐带分离。
