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70例新生儿锁骨骨折的相关因素及护理

Risk factors and nursing for 70 neonates with clavicle fracture

    摘要
  • 摘要:
      目的  探讨70例新生儿锁骨骨折的相关因素与护理。
      方法  选取2014年1月—2018年12月本院收治的70例锁骨骨折的新生儿设为观察组，另选取同期70例未发生锁骨骨折的新生儿设为对照组，比较2组临床资料，分析危险因素，并采取相应的护理干预措施。
      结果  本研究中，新生儿锁骨骨折发生率为0.19%(70/36 000), 患儿临床表现为哭闹、患侧上肢受限、患侧锁骨局部肿胀、淤血、骨擦音及拥抱反射消失。70例锁骨骨折新生儿中, 5例于分娩时被发现, 65例在出生24 h内被发现，并经影像学确诊; 58例锁骨不完全骨折患儿采用三角巾悬吊上肢; 12例锁骨完全骨折采用“∞”字绷带固定; 产后3周采用X线复查，见大量结痂生长, 1个月后均已愈合，且未发现畸形或功能障碍。2组的产妇年龄、产妇体质量指数、分娩方式、第二产程时间及脐带绕颈、新生儿出生体质量情况比较，差异均有统计学意义(P < 0.05); Logistic多因素回归分析显示，产妇年龄(OR=1.43, 95%CI: 1.12~1.82)、产妇体质量指数(OR=1.42, 95%CI: 1.13~1.79)、分娩方式(OR=1.42, 95%CI: 1.13~1.77)、第二产程时间(OR=1.39, 95%CI: 1.12~1.73)、脐带绕颈(OR=1.39, 95%CI: 1.13~1.71)和新生儿出生体质量(OR=1.34, 95%CI: 1.10~1.63)为新生儿发生锁骨骨折的独立危险因素(P < 0.05)。
      结论  新生儿锁骨骨折的预后良好，产妇年龄、分娩方式、第二产程时间、脐带绕颈及新生儿出生体质量为新生儿发生锁骨骨折的独立危险因素，临床应采用相应的护理干预措施，以降低新生儿锁骨骨折的发生率。

     

    Abstract:
      Objective  To investigate the related factors and nursing of 70 neonates with clavicle fracture.
      Methods  A total of 70 neonates with clavicle fracture admitted to our hospital from January 2014 to December 2018 were enrolled as observation group, another 70 neonates without clavicle fractures in the same period were enrolled as control group. The clinical data were compared between the two groups. Their risk factors and corresponding nursing intervention were analyzed.
      Results  The incidence of clavicle fracture was 0.19%(70/36 000). The clinical manifestations included crying, upper limb limitation of affected side, local swelling of affected affected clavicle, congestion, bone rubbing sound and disappearance of embrace reflex. Out of 70 neonates with clavicle fracture, the fracture was found in 5 cases during delivery, and 65 cases within 24 h after delivery, who were all confirmed by imaging diagnosis. The upper limbs were suspended by triangular towel in 58 patients with incomplete clavicle fractures, fixed by the "∞" shaped bandage in 12 patients with complete clavicle fractures. At 3 weeks after delivery, X-ray examination was performed for recheck, revealing that a large number of scab presented in fracture locations. After 1 month, they were healed and there were no abnormalities or dysfunction. There were significant differences in maternal age, maternal body mass index, delivery mode, duration of second stage of labor, umbilical cord around the neck, birth weight of neonates between the two groups (P < 0.05). Logistic multivariate regression showed maternal age (OR=1.43, 95%CI: 1.12~1.82), maternal body mass index (OR=1.42, 95%CI: 1.13~1.79), delivery mode (OR=1.42, 95%CI: 1.13~1.77), time of second stage of labor (OR=1.39, 95%CI: 1.12~1.73), umbilical cord around neck (OR=1.39, 95%CI: 1.13~1.71) and fetal birth weight (OR=1.34, 95%CI: 1.10~1.63) were independent risk factors for clavicle fracture in neonates (P < 0.05).
      Conclusion  Neonates with clavicle fracture have better prognosis. Maternal age, delivery mode, duration of second stage of labor, umbilical cord around the neck and birth weight of neonates are independent risk factors for neonates with clavicle fracture. Meanwhile, corresponding nursing measures should be taken to reduce incidence of clavicle fractures.

     

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