新生儿感染性肺炎危险因素分析与预防措施

Risk factors for infectious pneumonia in neonates and prevention measures

目的探讨新生儿感染性肺炎病原菌特点及其危险因素,预防措施分析,为临床治疗新生儿感染性肺炎提供依据。方法回顾性分析2012年4月-2015年3月医院新生儿科住院治疗的1064例新生儿临床资料,其中感染性肺炎96例,分析其病原菌分布及相关危险因素,采用SPSS 18.0软件进行统计分析。结果 1 064例新生儿有96例发生感染性肺炎发生率为9.02%,共检出病原菌102株,其中革兰阴性菌占67.65%、革兰阳性菌占30.39%、真菌占1.96%;革兰阴性菌主要以大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌为主,革兰阳性菌主要以金黄色葡萄球菌为主;单因素分析发现胎龄小、出生体质量低、血清白蛋白水平低、羊水污染、胎膜早破、宫内窘迫、气管插管是新生儿感染性肺炎的危险因素(P<0.05);多因素非条件logistic回归分析发现出生体质量低、血清白蛋白水平低、羊水污染、胎膜早破、宫内窘迫、气管插管是新生儿感染性肺炎的独立危险因素(P<0.05)。结论新生儿感染性肺炎与多种因素有关,需采取相应措施降低感染性肺炎发病率。

OBJECTIVE To explore the distribution of pathogens causing infectious pneumonia in neonates and analyze the risk factors so as to provide guidance for clinical treatment of the neonates with infectious pneumonia.METHODS The clinical data of 1064 neonates who were hospitalized the neonatology department from Apr 2012 to Mar 2015 were retrospectively analyzed,and 96 neonates had infectious pneumonia.The distribution of pathogens and the related risk factors were observed,and the statistical analysis was performed with the use of SPSS 18.0software.RESULTS The infectious pneumonia occurred in 96 of 1 064 neonates,with the incidence rate 9.02%.A total of 102 strains of pathogens were isolated,of which 67.65% were gram-negative bacteria,30.39% were gram-positive bacteria,and 1.96% were fungi.Escherichia coli,Klebsiella pneumoniae,and Acinetobacter baumannii were the major species of the gram-negative bacteria;the Staphylococcus aureus was the predominant species of the gram-negative bacteria.The univariate analysis showed that the risk factors for the infectious pneumonia in the neonates included the small gestational age,low birth weight,low level of serum albumin,contamination of amniotic fluid,premature rupture of membranes,fetal distress,and endotracheal intubation（P0.05）.The non-conditional multivariate logisticregression analysis indicated that the independent risk factors for the infectious pneumonia in the neonates included the low birth weight,low level of serum albumin,contamination of amniotic fluid,premature rupture of membrane,fetal distress,and endotracheal intubation（P0.05）.CONCLUSION There are a variety of factors that are associated with the infectious pneumonia in the neonates,and it is necessary to take targeted measures so as to reduce the incidence of the infectious pneumonia.