| 【Objective】This study compared the effects of different umbilical cord ligation sites and length of umbilical cord stump on umbilical cord complications,and umbilical cord separation time,to explore the appropriate umbilical cord ligation site and length of umbilical cord stump.In addition,the relevant factors affecting the time of umbilical cord separation in newborns were analyzed to explore the influence of related factors on the umbilical cord separation.It provides suggestions and references for care and operation of newborn umbilical cord,and enrichees the related research of newborn umbilical cord.【Methods】From April 2019 to December 2019,510 cases eligible of newborns in the first affiliated Hospital of Hainan Medical College were selected as the study subjects.They were divided into three groups,A,B and C,with 170 cases in each group.The intervention methods of each group were:Group A umbilical cord ligation site on 3cm,Length of umbilical cord stump 5cm;Group B umbilical cord ligation site on 0.5cm,Length of umbilical cord stump 5cm;Group C umbilical cord ligation site on 0.5cm,Length of umbilical cord stump 2cm.General data of neonates,umbilical cord complications(umbilical cord stump bleeding,umbilical inflammation,umbilical granuloma)and the time of umbilical cord stump shedding were recorded during hospitalization,and relevant data were collected by telephone follow-up after discharge.The main statistical methods are as follows: SPSS 22.0 statistical software is used for statistical analysis of collected data,mean ± standard deviation is used for statistical description,and analysis of variance or non-parametric test is used for general data.Anova was used in the comparison of three groups of umbilical cord stump shedding time.Independent sample t test was used in single factor analysis.Multivariate statistical analysis was carried out by regression analysis.The test level is defined as value =0.05.【Results】1.A total of 510 cases were included in this study for result analysis,among which 170 cases were included in group A,B and C,and there was no statistically significant difference in age and education level demographic data of parturient in group A,B and C(P>0.05).There were no statistically significant differences in neonatal gestational week,delivery mode,gender,birth weight,1-minute Apgar score,postpartum environment,among the included samples of the three groups(P>0.05).2.The incidence of umbilical cord stump bleeding,omphalitis and umbilical granuloma in the neonates of group A,B and C was 0.3.The time of umbilical cord separation time in group A was(10.98±3.49)d,that in group B was(10.58±3.79)d,and that in group C was(10.62±4.07)d.There was no statistically significant difference between the three groups(P > 0.05).4.In the single factor analysis,the factors influencing the time of umbilical cord separation include gestational week,delivery mode,birth weight,and postpartum environment.4.1 In the umbilical cord ligation site,the time of cord separation was(10.98±3.49)d at 3cm from the umbilical root,and(10.58±3.79)d at 0.5cm from the umbilical root,with no statistically significant difference(P> 0.05).4.2 In the length of umbilical cord stump,the time of cord separation was(10.58±3.79)d at the length of umbilical cord stump of 5cm,and the time of cord separation was(10.62±4.07)d at the length of umbilical cord stump of 2cm,with no statistical significance(P > 0.05).4.3 In the newborn gender,the time of umbilical cord separation was(10.67±3.82)d in males and(10.80±3.75)d in females,with no statistically significant difference(P> 0.05).4.4 In the gestational week,the time of umbilical cord separation was(12.93±3.44)d for premature delivery(< 37w)and(9.76±3.52)d for full-term(≥37w),with statistically significant differences(P<0.001).The time of umbilical cord separation is longer in premature than in full term.4.5 In the delivery mode,the time of umbilical separation in vaginal delivery was(9.32±3.96)d,and that in cesarean section was(11.95±3.16)d,the difference was statistically significant(P<0.001).The time of umbilical separation in cesarean section is longer than that in vaginal delivery.4.6 In the birth weight,the time of umbilical separation in low birth weight infant was(12.95±3.21)d,and that in normal birth weight infant was(10.02±3.68)d,the difference was statistically significant(P<0.001).The time of umbilical separation in low birth weight infant is longer than that in normal birth weight infant.4.7 In the postpartum environment,he time of umbilical separation in postnatal wards was(7.47±2.70)d,and that in the NICU was(12.11±3.30)d.the difference was statistically significant(P<0.001).The time of umbilical cord separation in the NICU is longer than that in postnatal wards.5.The results of multiple linear regression showed that the factors influencing the time of umbilical cord separation included delivery mode and postpartum environment.The results of multiple linear regression showed in the gestational week(standard regression coefficient =-0.097,t=-1.877,95% confidence interval:-1.638 ~0.037,P>0.05).In the delivery mode(standard regression coefficient =0.137,t=3.539,95% confidence interval: 0.463 ~ 1.619,P<0.001).In the birth weight(standard regression coefficient =-0.090,t=-1.820,95% confidence interval:-1.649 ~ 0.063,P>0.05).In the postpartum environment(standard regression coefficient =0.446,t=11.149,95% confidence interval: 3.039 ~ 4.339,P< 0.001).【Conclusions】1.The ligation site and length of umbilical cord stump do not affect the time of umbilical cord separation and do not increase the incidence of umbilical complications.The retention umbilical cord ligation site and length of umbilical cord stump can be selected according to the neonatal umbilical cord.2.Gestational weeks and birth weight are the factors affecting the time of umbilical cord separation,In the gestational week,the time of umbilical cord separation is longer in premature than in full term.In the birth weight,the time of umbilical separation in low birth weight infant is longer than that in normal birth weight infant.3.The mode of delivery and the environment of the newborn after birth are the influencing factors of umbilical cord separation.In the mode of delivery,the time of umbilical cord separation in cesarean section is longer than that in vaginal delivery;In postpartum environment,the time of umbilical cord separation in the NICU is longer than that in postnatal wards.4.Considering that the low umbilical cord ligation site is associated with the risk of skin damage in the intestine and around the umbilicus,it is recommended that the umbilical cord ligation site should be 3cm away from the umbilicus root.The retention length of the stump should be about 1-2cm away from the ligation site.It is recommended that the retention length of the umbilical cord stump should be 4-5cm. |
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