60例新生儿败血症的临床分析

Neonatal Sepsis: A Clinical Analysis of 60 Cases

目的:分析我院新生儿败血症的临床特征、实验室检查特点及危险因素,提高对该病的认识及治疗水平。方法:选择2009年2月至2012年2月入住我院新生儿病房的60例新生儿败血症患儿,其中早发型败血症(EOS)24例,迟发型败血症(LOS)36例。对患儿的临床特征、实验室检查特点等进行回顾性分析。结果:EOS多发生于足月儿和近足月早产儿(79.2%),LOS多发生于胎龄<34w的早产儿(50.0%)和极低出生体重儿(41.7%);LOS组患儿反应低下、喂养困难、呼吸困难的发生率明显高于EOS组(P均<0.05);EOS组白细胞增多、血小板减少、超敏C-反应蛋白(HsCRP)升高较LOS组多见(P均<0.05);两组患儿病原菌均以革兰阳性菌和条件致病菌为主,其中葡萄球菌最多,其次是大肠埃希菌、B族链球菌(GBS)。结论:早发型败血症多发生于足月儿,而迟发型败血症多见于早产儿和极低出生体重儿。

Objective： To analyze the clinical features, laboratory features and risk factors of neonatal sepsis, in order to enhance understanding of the disease and treatment level. Metilods ： The clinical features and laboratory features of 60 cases of neonatal sepsis, including 24 cases of early onset sepsis （EOS） and 36 cases of late onset sepsis （LOS） were analyzed. Results： EOS occurred in term infants and near full-term infants （79.2%）, and LOS occurred in the pretenn infants less than 34 weeks gestational age （50%） and very low birth weight infants （41.7%）. The incidences of reduced activity, dyspnea and feeding difficulties in LOS group were higher than those in EOS group （P〈0. 05）. Leukocytosis, thrombocytopenia, the increase of HsCRP in EOS group were more common than those in LOS group （P〈0.05）. In two groups, pathogens were mainly Gram-positive bacteria and opportunistic pathogens. Among them, the major pathogen was Staphylococcus aureus, followed by Escherichia eoli and GBS. Conclusions： Early onset sepsis occurred in term infants, and late onset sepsis occurred in premature and very low birth weight infants.