The umbilical cord is the fetus andplacentaConnection structure between.The shape is like a rope, the surface is smooth and transparent, containing connective tissue, an umbilical vein and a pair of umbilical arteries.The umbilical vein is connected with the fetal aorta along the inner side of the fetal abdominal wall through the hepatic sinuses and umbilical artery.The other end of these two blood vessels forms many interrelatedCapillary network, distributed in placental villi.The material exchange between the fetal disc fluid and the maternal blood in the villous space is carried out through the infiltration of the placental villous epithelium.
The tubular structure connecting the fetus and placenta in mammals.It was wrapped in amniotic membraneYolk sacAnd the stalk like elongation of the urinary membrane.The blood vessels in the umbilical cord passing through the urinary membrane areumbilical arteryandUmbilical vein, the blood vessel of yolk sac is the umbilical cordMesenteric arteryAnd umbilical mesenteric vein.When the yolk sac and its blood vessels degenerate, the umbilical artery and umbilical vein develop, and loose, gelatinous mesenchyme can be seen in these spaces.In the uterus, the capillaries of the uterine artery in the maternal part of the placenta are close to the fetal capillaries in the fetal part of the placenta, where CO is carried out between the maternal and fetal bloodtwoAnd OtwoMetabolites are the exchange of metabolic wastes and nutrients.The umbilical artery transports waste from the fetus to the placenta, and the umbilical vein transports OtwoAnd nutrients from the placenta to the fetus.Finally, the metabolic waste from the fetus is transported away by the uterine vein.Certain hormones and antibodies are also transferred from the mother to the fetus through the umbilical cord.In addition, in amniotic animals other than mammalsembryoThe yolk sac below the embryo body is also called the umbilical cord.
Infant umbilical cord care
Stage I: before the umbilical cord falls off
First, when nursing the umbilical cord, you must wash your hands to prevent the bacteria on your hands from infecting your baby's umbilical cord.
Second, when the baby takes a bath, do not let the umbilical cord get wet before it falls off.If you swim for your baby in the neonatal stage, you must wear waterproof stickers.
Third, the umbilical cord and its surrounding skin should be kept dry and clean, especially the diaper should not cover the umbilical cord to prevent urine or feces from contaminating the umbilical cord wound.
Fourth, do not use purple potion. Some babies' navels do not fall off for a long time, or become purulent after falling off. Some elderly people have to wipe their babies with purple potion in order to dry the umbilical cord. This method was often used before, but it is not recommended in medicine because the drying effect of purple potion is limited to the surface, while the drying effect of alcohol is from the inside to the outside.
Fifth, wipe twice a day with 75% alcohol swab, once in the morning and once in the evening.When wiping, lift the small string at the ligation part of the umbilical cord with one hand, and fully wipe the connection between the umbilical cord and the meat with a cotton swab dipped in alcohol with the other hand.At this time, it should be noted that if the cotton swab is dirty, it should be replaced in time. Do not wipe it repeatedly with the dirty cotton swab, which will cause infection and inflammation.
The second stage: after the umbilical cord falls off
After the umbilical cord falls off, there is often a small amount of exudate in the umbilical fossa, which can be used75% alcoholClean the navel nest with cotton swab, and then cover it with sterile gauze.It was once advocated to apply 1% methyl violet (purple potion) locally. Because methyl violet has sterilization and convergence effects, but because of its weak penetration, sometimes the epidermis has scab formation but there is abscess under it, so most people advocated to use cotton swabs dipped in 75% alcohol for disinfection.
But do not sprinkle "anti-inflammatory powder" on the navel to prevent infection.If the umbilical fossa has purulent secretion, the surrounding skin is red, swollen, and hot, and the child has anorexia, vomiting, fever, or body temperature does not rise (the anal surface temperature is lower than 35 degrees Celsius), it indicates that there is omphalitis, and you should go to the hospital immediately for treatment.
After the doctor's inspection, the baby in good health can be quickly sent to her mother's side.Under normal circumstances, the umbilical cord falls off 3 to 7 days after birth.But before the umbilical cord falls off, the umbilical cord is easy to become a hotbed for bacterial reproduction.After the umbilical cord is ligated, there is an umbilical vascular fracture. If the umbilical cord is infected, bacteria and their toxins enter the umbilical vascular fracture and enter the blood circulation, which will cause bacteremia.newbornLow immune function, bacteremia will quickly develop into sepsis and even sepsis.Therefore, the nursing of the broken end of the umbilical cord is very important.The medical staff will carefully carry out disinfection and other measures, and will carefully teach the baby's family how to care for the umbilical cord.After returning home, parents can take proper care of the umbilical cord until it dries and falls off.
matters needing attention
(1) Clean the navel every day
Newborn babies often have secretions in the umbilical fossa. After the secretion is dry, it will cause adhesion between the umbilical fossa and the root of the umbilical cord, which is not easy to clean, and pus may appear in the umbilical fossa.Therefore, the small umbilical fossa should be thoroughly cleaned.The method is: dip a cotton swab into 75% alcohol every day, gently lift the umbilical cord ligation line with one hand, and carefully wipe the umbilical fossa and the root of the umbilical cord with the alcohol swab with the other hand to make the umbilical cord no longer adhere to the umbilical fossa.Then, use a new alcohol swab to wipe from the center of the umbilical fossa in a circle outward.After cleaning, don't forget to disinfect the ligature with alcohol.
(2) Keep your navel dry
Before the baby's umbilical cord falls off or when the newly fallen umbilical fossa is not dry, it must be ensured that the umbilical cord and the umbilical fossa are dry, because the umbilical cord that is about to fall off is a kind of necrotic tissue, which is easy to be infected with bacteria.Therefore, once the umbilical cord is wetted by water or urine, it should be immediately wiped with a dry cotton ball or clean soft gauze, and then sterilized with an alcohol swab.Before the umbilical cord falls off, the baby should not be allowed to bathe in the bathtub.You can wash the upper part of your body first, dry it and then wash the lower part of your body.
(3) Do not let diapers or clothes rub the umbilical cord stump
When the umbilical cord is still or just falls off, it is necessary to avoid the stimulation of clothes and diapers on the baby's umbilical cord.The upper end of the front of the diaper can be turned down to reduce the friction of the diapers on the umbilical cord stump.
(4) If the umbilical cord does not fall off
Generally, the baby's umbilical cord will slowly become black and hard, and fall off in 1 to 2 weeks.If the baby's umbilical cord does not fall off after 2 weeks, carefully observe the condition of the umbilical cord. As long as there is no sign of infection, such as no redness, swelling or suppuration, and no large amount of fluid exudes from the umbilical fossa, don't worry.In addition, alcohol can be used to wipe the umbilical fossa for the baby to keep the umbilical cord stump dry and accelerate the umbilical cord stump shedding and navel healing.
(5) If the umbilical cord has secretions
The umbilical cord stump in healing often exudes clear or yellowish viscous liquid.This is the fluid oozing from the umbilical cord stump in healing, which is a normal phenomenon.After the umbilical cord naturally falls off, the umbilical fossa will be slightly wet and a little rice soup like liquid will exude. This is because the surface of the umbilical cord that falls off has not fully grown, and the liquid in the granulation tissue will exude. Wipe it gently with 75% alcohol.Generally, once or twice a day, the umbilical fossa will dry after 2-3 days.Gently wiping the umbilical cord stump with dry gauze can also accelerate the healing of the navel.If the exudate from the navel looks like pus or has a foul smell, it indicates that the navel may be infected, and the baby should be taken to the hospital.
(6) If the umbilical cord turns red
Once the umbilical cord stump falls off, the navel is formed.In the process of umbilical cord stump falling off, slight redness often appears around the navel, which is a normal phenomenon in the process of umbilical cord stump falling off. Don't worry.However, if the navel and the surrounding skin become very red, and the skin feels hot when touching, it is likely that the navel has an infection, and you should take your baby to see a doctor in time.
Parents should pay special attention to umbilical hernia when nursing the umbilical cord of newborn babies, which is a common disease in children.
Some babies, especially preterm infants, will have a protruding round mass at the navel after the umbilical cord falls off, which is called "umbilical hernia".It is as small as a soybean and as large as a walnut. When a child lies flat and quiet, the lump disappears, but when he is upright, crying, coughing, and defecating, the lump protrudes.If you press the protrusion with your finger, the mass can easily return to the abdominal cavity, and sometimes you can hear the sound of "grunting". If you put your finger into the umbilical hole, you can clearly feel the edge of the umbilical hernia.
1. Causes of umbilical hernia:
After the baby's umbilical cord fell off, the rectus abdominis on both sides of the umbilical hole had not yet closed. Once the pressure in the abdominal cavity increased, the peritoneum would protrude outward and cause hernia.The contents of the umbilical hernia are part of the intestinal canal.
2. Measures to help umbilical hernia heal naturally:
With the increase of age, the hernia ring mouth will also gradually shrink, and it can be naturally closed internally after the age of 2. Therefore, as long as there is no abdominal pain, vomiting (intestines trapped by the ring mouth) or local infection, no special treatment is generally required.
If the umbilical hernia is large, in order to speed up its healing, take an elastic band about 4-5cm wide, fix half of the table tennis ball with cloth at its center, align the convex surface of the ball with the umbilical hole, so that the intestines no longer protrude, and fix the two ends of the elastic band with adjustable buttons. The pressure should be kept to ensure that the intestines no longer protrude without affecting breathing and feeding,Check every 2-3 hours after use to preventSkin abrasions。
It is worth noting that some people once advocated pressing with coins or bandages, but the effect was not ideal. Because the baby's abdomen was round, and too tight bandages would cause local skin necrosis, it should be pressed with table tennis ball, which is safe and good.[1]
Health and disease
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Normal umbilical cord manifestation
The longitudinal section of the umbilical cord is like a long rope in amniotic fluid, which looks like a twist.Two umbilical arteries spiral around the umbilical vein.The envelope of the umbilical cord and the vascular wall are strongly echoic, and the lumen is anechoic.On the cross section, there are three dark areas arranged in a "pin" shape, with large veins and fluctuating arteries.The diameter of the cross section is about 1-2 cm.Color Doppler examination can display color image and arteriovenous spectrum.
Umbilical cord abnormality
1、Umbilical cord winding: Obvious indentation can be seen on the surface of the fetus at the umbilical cord winding part, with round or oblate hypoechoic small masses above the indentation;There is a short strip or equal sign echo inside the mass. The umbilical cord is wound around the neck for 1 week. The skin impression is "U" shaped, and there is a small mass above it;It is in "W" shape around 2 circles, and there can be 2 small packages above;If it is more than 3 weeks old, it may appear zigzag, and the upper mass is often beaded, but it is difficult to show if the neck of the fetus is lack of amniotic fluid.
2. Lack of umbilical artery: most of the umbilical arteries are reduced, with only one umbilical artery, whose lumen can be equal to the vein, about 25% - 50% of which are complicated with other malformations.
3. Umbilical cord cyst: round, smooth surface, no echo inside. The umbilical cord can attach to the cyst and float in amniotic fluid. There is no blood vessel inside the cyst.The older can compress the umbilical cord and affect the development of the fetus.
4. Umbilical cord hematoma: it is often caused by umbilical vein puncture, and it can also be caused by umbilical cordvaricosityCaused by rupture.The blood flows into the Huatong's colloid to form a hematoma, which may be manifested as an irregular and locally prominent liquid mass, and in serious cases, it may cause fetal death in utero.
Related diseases
After the umbilical cord is ligated, the umbilical cord must be kept clean, hygienic and dry. After cleaning the umbilical cord with hydrogen peroxide or 75% alcohol, apply 1% - 2% purple solution, and then wrap it with disinfectant gauze.
Umbilical pulp tooth swelling is the result of long-term incurable omphalitis, or it is caused by the misuse of talcum powder, umbilical cord powder, talcum powder and other foreign objects in the umbilical region.Should go to the hospital with 10% silver nitrate cauterization or surgical resection.
There is a spherical or hemispherical tumor with the size of a walnut on the appearance of the umbilical hernia, which can disappear when the child is quiet or in bed.Generally, it can heal itself. If it still does not heal at the age of four or five, it should be repaired by surgery.
Umbilical cord prolapse: There are abdominal viscera protruding out of the umbilical cord at the omphalocele. The external surface of the viscera is covered by a capsule composed of peritoneum and amnion, and there is no skin on the surface.The swollen viscera are clearly visible in the abdominal wall.If not treated in time, once the capsule ruptures and the viscera are exposed, peritonitis and septicemia may occur.Therefore, once diagnosed, surgical repair should be performed as soon as possible.
If the fetal membrane has been broken and the umbilical cord is further detached from the lower part of the fetal presentation, it enters the vagina through the cervix, or even exposed to the vulva through the vagina, it is calledProlapse of umbilical cord（prolapseofcord）。The umbilical cord is located in front of or on one side of the fetal presentation, and the fetal membrane is not broken, which is called presentation of cord.Umbilical cord presentation is actually mild umbilical cord prolapse, also known as recessive umbilical cord prolapse.
Umbilical cord blood is the blood that remains in the placenta and umbilical cord after the fetus is delivered, the umbilical cord is ligated and severed, and is usually discarded.In recent decades, research has found that umbilical cord blood containsimmune systemHematopoietic stem/progenitor cells ofhematopoietic stem cell transplantation, to treat a variety of diseases.Therefore, umbilical cord blood has becomeHematopoietic stem cellsIt is an important source of hematopoietic stem cells, especially unrelated hematopoietic stem cells.It is also a very important human biological resource.andmesenchyma stem cellMesenchymal stem cells, mainly from placenta and umbilical cord, have become a new research and application hotspot.
Hematopoietic stem cells in cord blood can be used to treat a variety of blood system diseases and immune system diseases, including hematological malignancies (such as acute leukemiaChronic leukemia、Multiple myeloma, myelodysplastic syndrome, lymphoma, etc.), hemoglobin disease (such as marine anemia), bone marrow hematopoietic failure (such as aplastic anemia), congenital metabolic disease, congenital immunodeficiency disease, autoimmune disease, some solid tumors (such as small cell lung cancerNeuroblastoma, ovarian cancer, etc.).Beijing Cord Blood Hematopoietic Stem Cell BankUmbilical cord blood hematopoietic stem cells have been successfully provided to many patients. Only in the People's Hospital of Peking University and the Institute of Hematology of Peking University, more than 30 leukemia patients have been transplanted and treated, with an implantation rate of 83%.One patient with leukemia weighs 95kg, and the preservation quality of umbilical cord blood and the success rate of transplantation have reached the world's advanced level.
Umbilical cord blood has such a good use that it can be preserved.Umbilical cord blood can be stored inhematopoietic stem cell Curry.In the umbilical cord blood bank, after multiple medical processes such as detection, separation and preparation, the umbilical cord blood is frozen in cryogenic liquid nitrogen at - 196 ℃ and can be stored for a long time.Full name of umbilical cord blood bank“Umbilical cord blood hematopoietic stem cell bank”。It is a special medical institution specialized in extracting and preserving umbilical cord blood hematopoietic stem cells and providing patients with inquiries, also known internationally as CORDBLOODBANK, or LIFEBANK.It includes public library and self library.[2]
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traditional Chinese medicine
Umbilical cord, see Collection of Materia Medica.also calledKan Qi, navel, belly, belt, navel intestine, life end, Kan Qi.
① Organization name.A tube connecting the fetus and the placenta.It is about 50 cm long.It can supply blood and nutrient metabolism to the fetus, and keep the fetus moving in the uterine cavity.
② Chinese medicine name.The umbilical cord of a newborn baby.Sweet, salty and warm.Benefiting the kidney, absorbing qi and astringing sweat.Cure weakness and weakness,Insufficient HP, wheezing and coughing due to kidney deficiency, night sweating.Internal use: decoction, 1-2 pieces;Bake and grind the final clothes, 0.6-1.8g.This product containschondroitin sulfateIt also contains glycogen and lipids.
Source: umbilical cord of newborn baby.
Efficacy
It can nourish qi and blood, warm the kidney and absorb qi.
It can cure asthenia, fatigue, weakness, deficiency of qi and blood, wheezing and coughing due to stomach deficiency.
Channel tropism of nature and taste
Sweet, salty, warm
Usage and dosage
Internal use: at the end of research, 2-6 points;Or fry soup.
Processing method
Wash and bleach the umbilical cord.Boil the decoction of honeysuckle and licorice together with yellow rice wine and umbilical cord, take out after boiling, and dry.(1 yuan for every 20 umbilical cords, 1 jin of boiled water, 1 liang of yellow rice wine)
Identification of raw medicinal materials
The dry umbilical cord is thin and long, light yellow to black brown, 10~15cm long, with two arterial tubes and one venous tube, tough and hard to break.The air is slightly fishy.
Engineering terminology
Umbilical spacewalk
A bundle of pipelines for umbilical submersibles and other underwater devices to obtain gas, fresh water, electric energy and communication signals from the surface or underwater supply base.[3]
