极低体质量新生儿细菌感染相关因素的回归分析

Regression analysis of related factors for bacterial infections in very low birth weight infants

目的分析极低体质量新生儿(VLBWI)细菌感染相关危险因素,为临床防治提供参考。方法选取医院在2012年2月-2015年5月产科出生VLBWI 262例为研究对象,观察VLBWI临床症状及实验室检查结果,分析细菌感染的危险因素,采用SPSS 19.0软件进行统计分析。结果共调查VLBWI 262例,住院期间63例出现感染,感染率为24.05%,共发生感染174例次,例次感染率为66.41%,20例死亡,病死率为31.75%;单因素分析显示,孕母胎膜早破、胎龄小、体质量低等与VLBWI感染的发生具有相关性(P<0.05),多因素logistic回归分析显示,胎龄<28周、出生体质量<1 000g、机械通气、胎膜早破等是VLBWI细菌感染的危险因素。结论 VLBWI细菌感染危险因素包括胎龄、留置导管等,需要加强管理,改善NICU条件,降低细菌感染率和病死率。

OBJECTIVE To investigate the related risk factors for bacterial infections in the very low birth weight infants（VLBWI）so as to provide guidance for clinical prevention and treatment.METHODS A total of 262 VLBWI who were born in the department of obstetrics from Feb 2012 to May 2015 were recruited as the study objects,then the clinical symptoms of the VLBWI and laboratory examination results were observed,the risk factors for the bacterial infections were analyzed,and the statistical analysis was performed with the use of SPSS19.0software.RESULTS Of totally 262 VLBWI who were enrolled in the study,63 had the infections during the hospital stay,with the infection rate 24.05%;totally 174case-times of VLBWI had the infections,with the case-time infection rate 66.41%;totally 20 cases died,with the mortality rate 31.75%.The univariate analysis indicated that the incidence of the infections in the VLBWI was associated with the premature rupture of membranes,small gestational age,and low body mass index（P〈0.05）.The multivariate logistic regression analysis showed that the risk factors for the bacterial infections in the VLBWI included the less than 28 weeks of gestational age,less than1 000 g of birth weight,mechanical ventilation,and premature rupture of membranes.CONCLUSIONThe risk factors for the bacterial infections in the VLBWI include the gestational age and catheter indwelling.It is necessary to strengthen the management and improve the condition of NICU so as to reduce the incidence of bacterial infections and the mortality rate.