日本語AIでPubMedを検索
臍帯コロニー化と臍帯分離時間に及ぼす異なる防腐剤の影響
Impact of different antiseptics on umbilical cord colonization and cord separation time.
PMID: 28248676 DOI: 10.3855/jidc.7224.
抄録
序論:
世界中、特に発展途上国では、臍帯ケアの実践にはまだ不確実性がある。本研究の目的は、6つの異なる臍帯ケア法が結核率と臍帯分離時間に及ぼす影響を検討することであった。
INTRODUCTION: There is still some uncertainty on cord care practices all around the world, especially in developing countries. The aim of our study was to investigate the effects of six different umbilical cord care practices on the rate of colonization and cord separation time.
方法:
1群はドライケア、2～4群は分娩室で70％アルコール、4％クロルヘキシジン、またはポビドンヨードをそれぞれ単回塗布し、その後は中止、5群と6群は分娩室で70％アルコールまたは4％クロルヘキシジンをそれぞれ単回塗布し、退院まで6時間ごとに継続した。臍帯は2日目と3日目、5日目と7日目の間に羊膜炎の徴候がないか検査した。綿棒培養はすべての症例から2日目または3日目に採取した。
METHODOLOGY: A total of 516 newborns were randomly allocated to the following six umbilical cord care groups: group 1 received dry care; groups 2-4 received a single application of 70% alcohol, 4% chlorhexidine, or povidon-iodine in the delivery room, respectively, which were discontinued thereafter; groups 5 and 6 received a single application of 70% alcohol or 4% chlorhexidine, respectively, starting in the delivery room and continuing every six hours until discharge. Umbilical cords were examined on the second and third days and between the fifth and seventh day for signs of omphalitis. Swab cultures were taken on the second or third day from all cases.
結果:
臍帯分離時間（中央値[四分位間範囲]）は、群1（7[6-7]日）が最も短く、群3（10[7-12]日）および群6（10[8-12]日）が最も長かった（p＜0.001）。綿棒培養での臍帯結節は、3群と6群で有意に低かった（p＜0.001）。試験集団中8例（1.5％）に大腿骨炎が検出されたが，群間に有意差はなかった．
RESULTS: Cord separation time (median [interquartile range]) was the shortest for group 1 (7 [6-7] days) and the longest for group 3 (10 [7-12] days) and group 6 (10 [8-12] days) (p < 0.001). The cord colonization in the swab cultures was significantly lower in groups 3 and 6 (p < 0.001). Omphalitis was detected in eight (1.5%) patients among the study population, and there was no significant difference between the groups.
結論:
我々の研究では、両群ともに臍帯分離時間を有意に増加させたが、クロルヘキシジン塗布がコロニー化の減少に最も有効な薬剤であることが示された。
CONCLUSIONS: Our study showed that chlorhexidine application was the most effective agent in decreasing colonization, though it increased cord separation time significantly in both groups.