新生儿感染性休克的临床分析

Clinical analysis of neonatal septic shock

目的提高对新生儿感染性休克的认识,争取早发现、早治疗,以提高抢救的成功率。方法分析本院NICU2008年10月～2011年6月收治的42例感染性休克新生儿的临床表现、引起死亡的高危因素及实验室资料的治疗方案的有效性。结果 42例患儿中,25例新生儿痊愈,7例放弃治疗,10例死于感染性休克并发多脏器衰竭。临床早期表现均有反应差、嗜睡,肌张力低下、灌注不良,皮肤苍白发花。约46%的患儿伴有呼吸支持增加及呼吸节律的改变,仅31%的患儿有低血压。结论新生儿感染性休克病死率较高,休克往往发生在血压降低之前,早发现、及时有效地治疗至关重要。多脏器功能衰竭者预后差,累及脏器越多,病死率越高。

Objective To deepen the understanding of neonatal septic shock and to improve success rate of rescue in early discovery and treatment.Methods Forty-two cases with neonatal septic shock admitted in the neonatal intensive care unit in our hospital from October 2008 to June 2011,their clinical manifestations,high risk factors leading to death,effective ness of therapeutic regimen based on laboratory data were retrospectively analyzed.Results Among 42 children,25 cases were in total recovery,7 cases gave up treatment,and 10 cases died from septic shock accompanied by multiple organ fail ure.They in early stage all presented with poor response,somnolence,hypotonia,poor perfusion,and pallid skin.Besides,about 46% accompanied with increased respiratory support and changes of respiratory rhythm.Only 31% suffered from hy potension.Conclusion The fatality rate is high in neonatal septic shock which always occurs before blood pressure decreases.Therefore,early discovery and effective treatment in time are of vital importance.Prognosis is unfavorable for pa tients with multiple organ failure.The more organs they get involved,the higher mortality rate it is.