比較酒精擦拭與自然乾燥於新生兒臍帶護理之照護成效

Comparison of 95% Alcohol with Natural Drying Application in Newborn Umbilical Cord Care

本研究旨在比較使用95%酒精及使用消毒棉花棒拭淨之兩種臍帶護理方式，對於新生兒臍帶脫落的天數、臍帶感染率與主要照顧者照護滿意度之差異。採類實驗設計法，以2008年7月至2009年1月於北市某醫學中心出生之新生兒為研究對象。其中偶數日出生者，臍帶護理是採95%酒精進行擦拭；奇數日出生者，則無利用任何清潔液，單純以消毒棉花棒擦拭後之乾燥方式。而後以t檢定、卡方檢定與線性複回歸等進行資料分析。本研究共納入127名新生兒進行探討，酒精組64人，自然乾燥組有63人。研究期間，兩組新生兒皆無發生任何感染事件，且酒精組之平均臍帶脫落天數較自然乾燥組長（t=2.05;p=0.04），照顧者平均滿意度分數亦比自然乾燥組低（t=-2.82;p<0.01）。此為首次台灣探討95%酒精和消毒棉花棒擦拭之兩種不同臍帶護理方式對新生兒照護成效影響之實證研究。結果發現，對健康新生兒進行臍帶護理時，無須輔以酒精消毒，只要保持臍部乾燥即可。此結果可作為未來執行新生兒臍帶照護之實務參考。

Newborn infections at the umbilical cord area are common, often leading to omphalitis and septicemia. Choosing an appropriate method to clean the area is thus very important. The purpose of this study was to compare application of 95% alcohol with application of sterilized dry cotton for umbilical cord care in terms of time required for cord separation, rate of infection, and parental satisfaction. A quasi-experimental design was used. The neonates born from July 2008 to January 2009 at a medical center in Taipei participated in the study. Those who were born on even-numbered days were assigned to group A, in which 95% alcohol was applied to clean the umbilical cord. Those who were born on odd-numbered days were assigned to group B, in which sterilized dry cotton was applied to clean and render the area to air-dry. Collected data were analyzed using the Student t test, the chi-square test, and linear regression analysis. Of 127 health newborns participating in the study, 64 were in group A and 63 were in group B, respectively. During the study, no cases of infection of the cord area were observed. The cord separation time in group B was more quickly than in group A by nearly two days(t =2.05 ; p =0.04), as well as parental satisfaction was higher in group B than in group A(t =-2.82 ; p <0.01). To our knowledge, this is the first evidence-based study evaluating the effect with respect to application of 95% alcohol versus sterilized dry cotton in umbilical cord care among Taiwanese infants. Our results showed that swabbing with 95% alcohol may be unnecessary, and that application of sterilized cotton to keep skin dry is more effective and associated with higher parental satisfaction.