极低体质量新生儿早发型败血症的临床特点及相关因素分析

Clinical characteristics and risk factors of early-onset sepsis in very low birth weight infants

目的探究极低体质量新生儿早发型败血症的临床特点及相关因素。方法回顾性分析2013年12月-2017年6月医院收治的早发型败血症极低体质量新生儿129例的临床资料,并设为研究组,同期医院收治的未发生早发型败血症的极低体质量新生儿159例为对照组,观察两组患儿的临床特征、实验室检查特点,对比分析极低体质量新生儿早发型败血症相关因素。结果研究组患儿反应低下、体温异常、病理性黄疸发生率分别为59.69%,48.84%,53.49%高于对照组38.36%,28.30%,29.56%(P<0.001);研究组患儿血小板计数为(86.75±11.36)×109/L低于对照组,研究组CRP和PCT分别为(47.12±10.21)mg/L和(11.21±4.71)ng/ml高于对照组(P<0.05);129例患儿共检出病原菌59株,其中革兰阴性菌35株占59.32%,革兰阳性菌24株占40.68%;绒毛膜羊膜炎、围生期窒息、胎膜早破、胎盘早剥是极低体质量新生儿早发型败血症的相关因素(P<0.05)。结论极低体质量新生儿早发型败血症的相关因素较多,应采取积极措施降低发生率,了解该疾病的临床特点对提高治愈率十分重要。

OBJECTIVE To investigate the clinical features and risk factors of early-onset sepsis in very low birth weight infants.METHODS A total of 129 cases of very low birth weight infants with early-onset sepsis in our hospital from Dec.2013 to Jun.2017 were retrospectively analyzed and taken as the observation group.Meanwhile,159 cases of very low birth weight infants without early-onset sepsis during the same period were taken as the control group.The clinical and laboratory characteristics of the two groups were observed,and the risk factors of early-onset sepsis in very low birth weight infants were compared and analyzed.RESULTS The incidence of hypothermia,hypothermia and pathological jaundice in the study group was 59.69%,48.84%,53.49%,respectively,and38.36%,28.30%,29.56%in the control group,respectively（P〈0.001）.The platelet count of the infants in the observation group was（86.75 ±11.36）× 109/L,which was significantly lower than that in the control group.The CRP in the observation group was（47.12 ±10.21）mg/L and PCT was（11.21 ± 4.71）ng/ml,significantly higher than those of the control group（P〈0.05）.A total of 59 strains of pathogenic bacteria were detected in the129 cases of patients,including 35（59.32%）strains of gram-negative bacteria and 24（40.68%）strains of grampositive bacteria.Chorioamnionitis,perinatal asphyxia,premature rupture of membranes and placental abruption were high risk factors for very low birth weight infants with early-onset sepsis（P〈0.05）.CONCLUSION There are a variety of high risk factors for early-onset sepsis of very low birth weight infants.Various positive measures should be taken to reduce the incidence,and the understanding on the clinical characteristics of this disease is very important for improving the cure rate.