临床抗感染决策对NICU新生儿败血症心肌损害的影响

Effects of clinical anti - infection decision making on the myocardial injury in neonatal septicemia

目的研究临床首选不同抗生素的抗感染决策对NICU新生儿败血症心肌损害发生率的影响。方法采用前瞻性临床研究方法，分析了入住NICU的112例新生儿败血症患儿心肌损害的发生率与首选不同的抗生素及其抗感染治疗效果的关系。结果治疗有效者88例，心肌损害的发生率为43％，显著低于无效者（79％，P〈0．05）。抗感染疗效差，5d内需更换抗生素者心肌损害的发生率显著高于不需更换者（P〈0．05）。头孢地嗪（CDZ）组43例，心肌损害的发生率为33％，显著低于首选其他抗生素组，即复方抗生素组和单方抗生素组（70％，56％，P〈0．05）。结论尽早选择安全、有效的抗生素，减少抗生素的更换率，可降低新生儿败血症心肌损害的发生率。CDZ治疗新生儿败血症临床疗效好。

Objective To investigate the effects of clinical anti - infection decision making on the myocardial injury in neonatal septicemia. Methods A prospective, observational study was carried out. The correlations of the myocardial injury with the effective rates, the changed ratio within 5 clays, the first choice antibiotics were analyzed in 112 cases of neonatal septicemia. Results The myocardial injury rate （43% ） in 88 infants with successful treatment was significantly lower than that in the infants with failure treatment（79% ） （P 〈 0.05）. There was a positive correlation between the antibiotics changed ratio within 5 days and the myocardial injury in neonatal septicemia （ P 〈 0.05 ）. The myocardial injury rate （33%） in the 43 Cefodizime （CDZ） group （43 cases） was significantly lower than those in other antibiotics group （ 70% ,56% ） （P 〈 0.05）. Conclusion The safe and effective antibiotics and decrease of the antibiotics changed rate are key factors for cutting clown myocardial injury in neonatal septicemia. The CDZ had good clinical efficacy for neonatal septicemia.