Lum S H, Chew M F
Department of Paediatrics, Hospital Duchess of Kent, Sandakan, Sabah, Malaysia.
Med J Malaysia. 2009 Mar;64(1):80-2.
This study aims to study the demographics, clinical presentation, treatment and outcome of neonatal tetanus patients managed at Hospital Duchess of Kent from January 1st 2006 to December 31st 2006. Five neonates were studied. All presented with fever, poor sucking and limb stiffness, with a history of unsterile delivery and uncertain maternal tetanus immunity status. All were nursed in a minimal-stimuli environment and were given IV penicillin G, IM tetanus immunoglobulin and sedatives to control spasms. Nutrition and chest physiotherapy were rendered. Three patients required artificial ventilation. Duration of treatment ranged from 25 to 44 days. All survived. Inadequate maternal immunization, unsterile delivery and inappropriate umbilical cord care are major contributing factors of neonatal tetanus in our study. Supportive measures are the mainstay of treatment in our setting with very limited resources.
本研究旨在探讨2006年1月1日至2006年12月31日在肯特公爵夫人医院接受治疗的新生儿破伤风患者的人口统计学特征、临床表现、治疗方法及治疗结果。研究了5例新生儿。所有患儿均表现为发热、吸吮无力和肢体僵硬，有分娩时未消毒及母亲破伤风免疫状态不明的病史。所有患儿均在刺激最小的环境中护理，并给予静脉注射青霉素G、肌内注射破伤风免疫球蛋白及镇静剂以控制痉挛。提供了营养支持和胸部物理治疗。3例患者需要人工通气。治疗时间为25至44天。所有患儿均存活。在我们的研究中，母亲免疫不足、分娩时未消毒及脐带护理不当是新生儿破伤风的主要促成因素。在我们资源非常有限的情况下，支持性措施是治疗的主要手段。
