早发败血症早产儿81例临床分析

Clinical analysis of 81 premature infants with early-onset sepsis

目的：探讨早发败血症早产儿的防治措施。方法对81例早发败血症早产儿的临床资料、病原菌、高危因素及治疗预后进行回顾性分析。结果 NICU 早产儿早发败血症发生率为3.82%，病原菌中革兰阳性菌占64.29%，以溶血葡萄球菌为主；革兰阴性菌占29.76%，以大肠埃希菌为主；真菌占6.17%，以白色念珠菌为主。早产、极低出生体质量、剖宫产、气管插管、使用肺表面活性物质、产前使用激素和母亲感染是早发败血症发生的高危因素。结论 NICU 早产儿早发败血症病原菌以革兰阳性菌为主，应加强孕期管理，减少有创操作，严格无菌操作，产前合理使用激素及预防性抗真菌治疗，减少早发败血症及其并发症的发生率。

Objective To investigate the prevention and treatment of premature infants with early-onset sepsis. Methods The clinical data,pathogenic bacteria,high risk factors and treatment outcome of 81 premature infants with early-onset sepsis were retrospectively analyzed. Results The incidence of premature infants with early-onset sepsis in hospitalized neonates was 3. 82% . The most common pathogens were gram-positive bacteria（64. 29% ）,Staphylococcus aureus was the most common pathogen;Gram-negative bacilli accounted for 29. 76% , Escherichia coli was the most common pathogen;Fungi accounted for 6. 17% ,Candida albicans was the most pathogen. The high risk factors of early-onset sepsis were premature with low birth weight,cesarean section,tracheal intubation,use of PS, prenatal use of hormones and maternal infection. Conclusions The most common pathogens of NICU in premature infants with early-onset sepsis were mainly gram-positive bacteria. So we should strengthen preg-nancy management,reduce the invasive operation,standardized aseptic operation,use hormone reasonably and prophylactic antifungal therapy,reduce the occurrence of premature sepsis and its complications.