neonatal omphalitis
Introduction
Introduction to neonatal navel inflammation The umbilical cord is the passage for the fetus to supply fetal nutrition and fetal excretion waste in the mother's body. After the baby is born, the medical staff will ligature and cut the umbilical cord. After the umbilicus is broken, the stump of the umbilical cord gradually becomes dry and thin, and becomes black. Generally, the umbilical cord falls off 3-7 days after the baby is born, and the wound is easily infected and umbilical inflammation occurs before the umbilical cord falls off. Umbilical inflammation refers to acute inflammation caused by bacterial invasion and reproduction of the umbilical stump. The effects of foreign body stimuli lead to the possibility of umbilical inflammation. After the umbilical cord is detached, the wound is delayed, and the moist oozing fluid is the initial symptom of the infection, followed by redness and swelling of the skin around the umbilical cord, which affects the skin. The stump has purulent secretions, and the pus is stinky. It can also be seen that the abdominal wall is edematous and shiny, forming cellulitis and subcutaneous gangrene. Chronic inflammation often forms umbilical granuloma, which prevents the healing of umbilical wounds. basic knowledge The proportion of illness: 0.3% Susceptible people: infants and young children Mode of infection: non-infectious Complications: peritonitis neonatal subcutaneous gangrene cellulitis sepsis suppurative portal phlebitis
Cause
Causes of neonatal umbilical inflammation
Bacterial infection (60%):
When the umbilical cord is broken, or after the umbilicus is broken, it is caused by improper umbilical cord or improper treatment after birth. Disinfection is not strict, improper care can cause bacterial contamination, causing inflammation of the umbilicus. Common pathogens: Staphylococcus aureus, Escherichia coli, followed by hemolytic streptococcus, or mixed bacterial infections.
Other (10%):
The effects of foreign body stimuli lead to the possibility of umbilical inflammation. After the umbilical cord is detached, the wound is delayed, and the moist oozing fluid is the initial symptom of the infection, followed by redness and swelling of the skin around the umbilical cord, which affects the skin. The stump has purulent secretions, and the pus is stinky. It can also be seen that the abdominal wall is edematous and shiny, forming cellulitis and subcutaneous gangrene. Chronic inflammation often forms umbilical granuloma, which prevents the healing of umbilical wounds.
Prevention
Neonatal umbilical inflammation prevention
The key to prevention is strict aseptic operation when the umbilical cord is broken. The umbilical device and the ligature cord are strictly disinfected. In case of emergency, the disinfection is not strict during delivery. The umbilical cord should be re-opened within a few hours and the umbilical cord stump should be strictly disinfected.
Before and after the umbilical stump is detached, the diaper should be changed frequently to keep the umbilical clean and dry. 75% of medical alcohol can be used to rub the umbilical stump and 2-3 times around. If there is crusting, when the alcohol is rubbed, the knot should be lifted and rubbed from the inside to the outside to be truly disinfected.
It should also be noted that colored drugs such as gentian violet and red mercury should not be used, because the color of the drug can affect the observation of the umbilicus; do not use powdered drugs such as pine pollen and talcum powder, which can cause umbilical cord due to stimulation of powdery foreign bodies. Chronic inflammation forms granuloma and is not easy to heal.
If you notice the appearance of redness or umbilical inflammation such as purulent discharge in the umbilicus, you should go to the hospital in time.
Complication
Neonatal umbilical inflammation Complications, peritonitis, subcutaneous gangrene, cellulitis, sepsis, suppurative portal phlebitis
The lighter umbilical cord and the umbilical skin are slightly red and swollen, and may be accompanied by a small amount of serous discharge. In severe cases, the umbilicus and umbilical cord are obviously red and swollen, and the secretion is purulent and the amount is often odorous. Can spread to the surrounding skin or tissue, causing abdominal cellulitis, subcutaneous gangrene, peritonitis, sepsis, portal phlebitis, and later can develop portal hyperemia, cirrhosis.
Symptom
Neonatal umbilical inflammation symptoms Common symptoms Navel pain Newborn umbilical cord hemorrhage Umbilical cord redness umbilical cord infection Umbilical cord umbilical cord wet umbilical cord obvious redness and swelling of the umbilical cord umbilical fossa granulosa tissue proliferation umbilical cord purulent secretion more
The root of the umbilical cord is red, or the wound does not heal after detachment, and the umbilicus is moist and flowing. This is the earliest manifestation of umbilical cord inflammation. Later, the skin around the umbilicus is red and swollen. The umbilical fossa has serous purulent secretions, with odor, and the skin around the umbilicus is red and swollen, or forms a local abscess, sepsis, and the condition is critical, causing peritonitis and systemic poisoning symptoms. Fever, no breastfeeding, bad spirits, irritability, etc. In the case of chronic umbilical inflammation, umbilical granuloma is formed, which is a small cherry red mass protruding, often with sticky secretions, and is not cured for a long time.
Examine
Neonatal navel inflammation
1, clinical manifestations of umbilical cord root redness, or the wound does not heal after detachment, umbilical fossa moist, running water, this is the earliest manifestation of umbilical cord inflammation. Later, the skin around the umbilicus is red and swollen, and the umbilical fossa has serous purulent secretions with odor, and the skin around the umbilicus is red and swollen, or a local abscess is formed.
2, blood routine examination: blood routine examination is one of the most basic laboratory tests. Blood tests include red blood cells, white blood cells, hemoglobin, and platelet counts.
Diagnosis
Diagnosis and identification of neonatal umbilical inflammation
diagnosis
According to clinical manifestations, diagnosis can be performed.
Differential diagnosis
Neonatal umbilical inflammation should be differentiated from the following diseases
1. The umbilical sinus is caused by the umbilical end of the yolk tube. Carefully inspect the umbilicus and find the sinus with a probe or contrast agent. Sometimes it can be seen that the spheroidal polyp tissue section is the intestinal mucosa rather than the granulation tissue, which is called umbilical cord or umbilical polyp should be surgically removed.
2. Umbilical intestinal fistula (the yolk tube is not closed) A bright red mucosa with a rounded protrusion is visible in the umbilicus. There is a mouth in the middle, there is a foul odor secretion or liquid feces, oral charcoal or a contrast agent injected into the umbilicus. A line check can confirm the diagnosis. Need surgery.
3. Umbilical urethral fistula (ursal ureteral obstruction) The umbilicus often has clear liquid outflow, local injection of contrast agent can enter the bladder or bladder retrograde angiography to reach the skin, injecting methylene blue to the umbilicus to discharge blue urine. Need surgery.
