新生儿感染性休克的早期临床信号与病原分析

Early clinical signals and pathogens of septic shock in neonates

目的探讨新生儿感染性休克的早期信号与伴随症状，为临床早诊断、早治疗提供参考。方法回顾性分析某院2001年1月-2009年3月住院且符合感染性休克诊断标准的31例患儿资料。结果拒乳或吸乳量减少（29例，93．55％）、精神差（24例，77．42％）、烦躁（20例，64．52％）与反复青紫（11例，35．48％）为新生儿感染性休克的早期表现；出现早期表现后，病情进展迅速，大部分（27例，87．10％）在发病24h内即进入休克期。新生儿感染性休克病死率（19例，61．29％）高，2001-2005年，17例新生儿病死14例（82．35％）；2006-2009年，14例新生儿病死5例（35．71％），两阶段比较，差异有高度显著性（Х^2=77．04，P=0．008）。结论拒乳或吸乳量减少、精神差、烦躁及反复青紫是新生儿感染性休克的早期信号。及时识别和恰当的治疗可以挽救新生儿的生命。

Objective To evaluate the early signals and associated symptoms of septic shock in neonates, so as to provide reference for early diagnosis and treatment. Methods Thirty-one neonates who were hospitalized and diagnosed as septic shock in a hospital between January 2001 to March 2009 were analysed retrospectively. Results The early manifestations of neonatal septic shock were milk refusal or reduced milk acceptance （29 cases, 93.55%）, lassitude （24 cases, 77. 42%）, irritability （20 cases, 64. 52%）, repeated cyanosis（ll cases, 35.48%） ; Septic shock progressed rapidly, most neonates （27 cases, 87.10%） developed shock within 24 hours after onset. The mortality was high （19 cases, 61.29%） , 14 of 17 （82. 35%） neonates died during the period of 200l - 2005; 5 of 14 neonates （35.71 %） died between 2006 - 2009, there was significant difference between the two stages （Х^2 = 77. 04, P = 0. 008） . Conclusion The early signals of neonatal septic shock are milk refusal or reduction of milk acceptance, lassitude, irritability, repeated cyanosis. Timely recognition and proper treatment can save neonatal life.