Iijima Shigeo
Department of Regional Neonatal-Perinatal Medicine, Hamamatsu University School of Medicine, Hamamatsu 4313192, Japan.
J Clin Med. 2023 Sep 21;12(18):6104. doi: 10.3390/jcm12186104.
Umbilical granuloma (UG) is a common problem during the neonatal period; however, its epidemiology and etiology are poorly studied, and the best treatment option has not yet been established. We examined the medical records of neonates who were born and underwent 1-month evaluations at our hospital between 2013 and 2022 to investigate the frequency of-and factors associated with-UG, as well as the annual trends of UG treatments and their efficacy. Of the 6680 eligible neonates, 395 (5.9%) had UG. The annual incidence rate ranged from 3.8% to 7.3%. Gestational age, birth weight, and incidence of meconium-stained amniotic fluid were significantly associated with UG. Silver nitrate cauterization was the predominant UG treatment from 2013 to 2016. Silver nitrate cauterization and topical betamethasone valerate were nearly equally applied in 2017. Betamethasone application became predominant in 2018. The healing rates during the initial treatment period were 91% for silver nitrate cauterization, 97.7% for betamethasone application, 60% for ethanol disinfection, and 88% for ligation; these rates were significantly different ( < 0.001). Topical steroid application may be the most effective treatment. If steroid application is ineffective, then silver nitrate cauterization and ligation may be important treatment options.
脐肉芽肿（UG）是新生儿期的常见问题；然而，其流行病学和病因学研究较少，最佳治疗方案尚未确立。我们查阅了2013年至2022年期间在我院出生并接受1个月评估的新生儿的病历，以调查UG的发生率、相关因素，以及UG治疗的年度趋势及其疗效。在6680名符合条件的新生儿中，395名（5.9%）患有UG。年发病率在3.8%至7.3%之间。胎龄、出生体重和羊水胎粪污染发生率与UG显著相关。2013年至2016年，硝酸银烧灼是主要的UG治疗方法。2017年，硝酸银烧灼和外用戊酸倍他米松的应用几乎相同。2018年，倍他米松的应用成为主要方法。初始治疗期间的愈合率分别为：硝酸银烧灼91%，外用倍他米松97.7%，乙醇消毒60%，结扎88%；这些比率有显著差异（<0.001）。外用类固醇可能是最有效的治疗方法。如果类固醇治疗无效，那么硝酸银烧灼和结扎可能是重要的治疗选择。
