脐带感染（脐带炎）

Umbilical/Navel Infection (Omphalitis)

                                                        Prepared by: Dr. Terry Hunt

                                                          Translated by Dr. 傅小平

病因/发病机理   

Cause & Pathogenesis

• 脐带组织炎症    Inflammation of umbilical structures
• 脐带回动脉到胎盘   Umbilical arteries-internal iliac arteries to placenta
• 脐带肝静脉到胎盘   Umbilical vein-liver to placenta
• 膀胱脐尿管到尿囊腔  Urachus-apex of urinary bladder to allantoic cavity

危险因素   

Risk Factors

• 没有消毒条件    Unsanitary conditions
• 缺乏优质初乳    Lack of good quality colostrum

临床症状    Clinical Findings

·        脐带热肿疼痛    Hot enlarged painful navel

• 排出脓性分泌物       Purulent drainage from navel
• 体温升高         Elevated temperature
• 无食欲和萎靡    Anorexia and depression
• 若败血症——可能有脓毒性关节炎、肺炎、腹泻、脑膜炎、眼色素层炎

If septicemia – maybe septic arthritis, pneumonia, diarrhea, meningitis and uveitis

诊断     

Diagnosis

• 临床检查、触诊       Clinical examination and deep palpation

鉴别诊断   

Differential Diagnosis

• 脐疝            Umbilical hernia
• 脐尿管           Patent Urachus
• 其它并发症     Other complications

实验室和病理学诊断Laboratory and Pathology

• 检查初乳被动转移失败  Check for Failure of Passive Transfer (colostrum)

治疗     

Treatment

• 广谱抗生素全身治疗  Broad-spectrum systemic antibiotics
• 支持补液         Supportive fluids
• 确保脐带排泄    Ensure navel is draining
• 切除感染组织    May have to surgically remove infected structures

预后情况       

Prognosis

• 取决于感染度和初乳摄入

Depends on degree of involvement and colostrum intake

• 若的败血症和关节感染则不良  Poor if septicemia and spread to joints

后遗症                 Sequelae

• 败血症           Septicemia
• 脓毒性关节炎    Septic arthritis
• 骨髓炎           Osteomyelitis

预防     

Prevention & Control

• 清洁产房         Clean calving area
• 浸泡脐带         Dip navel
• 确保摄入优质初乳（12小时内体重的10%）

Insure adequate good quality colostrum (10% body weight within 12 hours)

• 不结扎脐带     Do not ligate navel