57例新生儿败血症临床特点及检验结果分析

Analysis of Clinical Characteristics and Positive Findings of 57 Cases of Neonatal Septicemia

目的:分析新生儿败血症的临床特点,为新生儿败血症治疗提供支持。方法:回顾性分析2013年1月至2017年8月新生儿科收治的57例新生儿败血症的临床诊治资料,并对阳性检验结果进行分析。结果:早发型败血症53例(92.98%),母亲有致病危险因素36例,排前3位的分别是胎膜早破14例(24.6%)、孕期感染8例(14.0%)、羊水污染8例(14.0%);患儿有多种症状者27例(35.09%),排前3位的为呕吐17人次(29.8%)、皮肤黄疸16人次(28.1%)、纳差14人次(24.6%);降钙素原、C反应蛋白、中性粒细胞杆状核/中性粒细胞、白细胞及血小板5项检查结果阳性率为59.64%、56.14%、38.77%、38.60%及5.66%;C反应蛋白和降钙素原水平呈正向相关,r=0.7,p<0.01;血培养阳性7例(12.28%),其中金黄色葡萄球菌2例,表皮葡萄球菌3例,溶血性葡萄球菌1例,大肠埃希菌1例。结论:综合参考实验检查的阳性指标,可提高新生儿败血症早期诊断。

Objective： To analyze the clinical characteristics of neonatal sepsis so as to provide guidance for the treatment of neonatal septicemia. Methods： The clinical data of 57 cases of neonatal septicemia was retrospectively analyzed,which were admitted to Department of Neonatology of Dongfang Group General Hospital（ Huainan）from January 2013 to August 2017. Results： Early onset neonatal septicemia occurred in 53 patients（ 92. 98%）among which 36 cases with maternal risk factors; the top 3 ranked were respectively Premature rupture of membranes（ 14,24. 6%）,Pregnancy infection（ 8,14%） and Amniotic fluid contamination（ 8,14%）. There were27 cases with multiple symptoms（ 35. 09%）,and the top 3 ranked were respectively 17 vomiting（ 29. 8%）,16 jaundice（ 28. 1%）,and 14 sucking difference（ 24. 6%）. The positive rates of Procalcitonin,C reactive protein,Neutrophil stab/Neutrophils percentage,Leukocytes and Platelets were respectively 59. 64% 、56. 14% 、38. 77 % 、38. 60% and 5. 66%. There was a positive correlation between the levels of Creactive protein and procalcitonin,r = 0. 7,p 〈 0. 01. Blood Culture were Positive in 7 cases（ 12. 28%）,including 2 cases of Staphylococcus aureus,3 cases of Staphylococcus epidermidis,1 case of hemolytic staphylococci,1 case of Escherichia coli. Conclusion： Comprehensive reference of the positive indexes can improve the early diagnosis rate of neonatal septicemia.