新生儿真菌性败血症的临床分析

Clinical analysis of neonatal fungal septicemia

目的 探讨新生儿真菌性败血症的临床特点,指导该病的预防和治疗.方法 选取广东省茂名市妇幼保健院新生儿科2011-01 ～2013-01治疗的42例新生儿真菌性败血症患儿,对其临床资料进行回顾性分析,比较治疗过程中感染指标的变化,如血常规的白细胞（WBC）、血小板（PLT）以及C反应蛋白（CRP）等.同时分析G-试验报告.结果 白色念珠菌是新生儿真菌性败血症的主要病原菌;首发症状往往缺乏特异性,常见者包括少吃、少动、少哭、反应差、发热、呼吸暂停等等;所选病例的G-试验都为阳性;感染指标的变化出现在大多数患儿,早期可见血小板减少和CRP升高,经氟康唑治疗后可恢复正常,但白细胞无明显变化.结论 新生儿真菌性败血症无特异性临床表现,对有高危因素者须密切观察感染相关症状并及时查感染指标和G-试验,力求早期发现、早期治疗.

Objective To study the clinical characteristic of neonatal fungal septicemia in order to guide the preven- tion and treatment of this disease. Methods 42 cases with neonatal fungal septicemia were treated in NICU from Jan- uary,2011 to January,2013 and the clinical data collected for retrospective analysis. The infection index were stud- ied, such as WBC, PLT and CRP and the G -Tests also. Result Candida albicans was the main pathogenic bacteria of neonatal fungal septicemia. The presenting symptoms had no specificity, such as lack of eating, movement and crying, poor response, fever, apnea, etc. All G - Tests were positive. The infection index had change in most cases. Reduction of PLT and rise of CRP appeared in prophase, and got back to normal after the treatment of Fluconazole. But the WBC had no apparent change. Conclusion Neonatal fungal septicemia has no specific clinical manifesta- tion. In order to diagnose and treat these patients in early stage, infection symptoms, infection index and G - Test must be concerned.