新生儿败血症患者血小板变化的临床意义

The clinic evaluation on the dynamic changes of platelet in patients with the neonatal septicemia

目的:探讨新生儿败血症患儿血小板动态变化与感染严重程度及其预后的关系。方法:回顾性分析本院2009年1月至2011年9月收治确诊的142例新生儿败血症病例,以是否合并重度休克将患儿分为2组:病情严重组(64例)和病情轻微组(78例),分析其血小板动态变化情况以及血小板减少程度与预后的关系。结果:142例患儿中,病情危重组和病情轻微组其在性别、胎龄、发病日龄方面比较,差异无统计学意义;血小板减少68/142例,血小板减少发生率47.8%,其64例为危重组,4例为轻微组;13/142例死亡,病死率为9.2%,其中死亡者均为危重组;病情严重组血小板计数明显低于病情轻微组,有统计学差异(P<0.05);病情严重组中死亡组与存活组的血小板的动态变化具有统计学意义(P<0.05)。危重患儿血小板输注治疗并不能降低死亡率。结论:新生儿败血症患儿的血小板动态变化情况可以及时反映其病情和预后,是新生儿败血症病情监测的一个可靠指标。

Objective：To investigate the clinical value of the platelet dynamic changes and the relationship of the dynamic changes of platelet between the infection severity and prognosis in patients with the neonatal septicemia. Methods： 142 cases of neonatal septice- mia treated in the Chengdu Maternal and Children Center Hospital from January 2009 to September 2011 were analyzed retrospectively. According to whether they had serious shock complication, these cases were divided into two groups ： The dynamic changes of the plate- let and the relationship between thrombocytopenia and prognosis were analyzed. Results：Among the 142 cases,between critical group and minor group,there were no difference in sex,gestational age and invasion age. The incident of thrombopenia was 47.8 % （68/ 142 ）. Among them, 64 cases belong to critical group ,4 cases belong to minor group. The morality was 9.2% （13/142） , all of the death cases belong to critical group. However, Platelet changes and the severity of sepsis were positively correlated（ P 〈 0.05 ）. The dynamic changes of platelet accompanying with the morality and prognosis （P 〈 0.05）. And platelet transfusion treatment cant reduce the mortal- ity for critically ill children. Conclusion：The dynamic changes of platelet can reflect severity of disease and prognosis of sepsis;and it is not only a reliable indicator of the condition monitoring, but also can suggest significant prognosis of sepsis.