极低出生体重儿医院感染的危险因素及血清营养素状况分析

Analysis of risk factors and serum nutrient status of very low birth weight infants with nosocomial infection

目的分析极低出生体重儿(VLBWI)发生医院感染的危险因素及血清营养素状况,为临床治疗提供新的思路。方法以收治的50例发生医院感染的VLBWI为研究对象,检测血清维生素A等营养素水平,对其病史、症状、体征、实验室检查等相关因素进行总结、分析。同期随机抽取50例未发生医院感染的VLBWI作为对照。结果小于胎龄儿、有创辅助通气、侵入性操作、外出检查、住院天数超过1周是极低出生体重儿医院感染的危险因素。医院感染组锌、维生素A、25-羟基维生素D[25-(OH)D]的缺乏率分别为36.0%、42.0%、34.0%,均显著高于对照组(16.0%,22.0%,20.0%;P均<0.05)。两组间钙、铁及镁缺乏率的差异均无统计学意义(P均>0.05)。结论发生医院感染的VLBWI中锌、维生素A、D缺乏普遍存在,应做到早发现、早治疗,以降低LVBWI的死亡率。

Objective To explore the risk factors and serum nutrient status of very low birth weight infant（VLBWI）with nosocomial infection.Methods Fifty VLBWI with nosocomial infection,from January 2013 to December 2016 in neonatology department of Lianshui County People＇s Hospital,were enrolled.The levels of serum vitamin A,25-hydroxyvitamin D,calcium,iron,magnesium and zinc were detected.And the related factors such as history,symptoms,signs and laboratory tests were summarized and analyzed.During the same period,50 cases without nosocomial infection were randomly selected as the control group.Results The risk factors for nosocomial infection included smaller than the gestational age,invasive assisted ventilation,invasive operation,out of the ward check,and hospitalized days more than a week,The deficiency rates of zinc,vitamin A and 25-hydroxyvitamin D in hospital infection group were 36.0%,42.0% and 34.0% respectively,which were significantly higher than those in control group（16.0%,22.0%,20.0%;P0.05）.There was no significant difference on calcium,iron and magnesium deficiency rates between the two groups（P0.05）.Conclusion Zinc,Vitamin A and Vitamin D deficiency are common in VLBWI with nosocomial infection.Early detection and treatment should be conducted in order to reduce VLBWI mortality.