新生儿肺出血合并宫内感染临床分析

Clinical Analysis of Neonatal Pulmonary Hemorrhage with Intrauterine infection

目的研究分析新生儿肺出血合并宫内感染临床治疗方法,讨论新生儿肺出血合并宫内感染主要临床特征,确定影响新生儿肺出血发生的高危因素,为新生儿肺出血预防提供参考。方法对比本院2014年4月~2016年8月期间收治的新生儿肺出血患儿59例,获得相应的临床资料作为研究材料,其中感染组患儿45例合并宫内感染;未感染组14例未合并宫内感染。通过对两组患儿各项基本信息的对比,归纳出导致肺出血合并宫内感染的产生原因,统计合并宫内感染发生部位、病原菌情况以及治疗方法有效性,确定高危因素。结果新生儿肺出血患儿59例中出现宫内感染的例数为45例(76.3%),对两组患儿肺透明膜病、新生儿窒息、早产、出生体质量<1 500 g等信息进行统计,比较差异具有统计学意义(P<0.05),通过多因素回归分析得出合并宫内感染的高危因素为肺透明膜病、新生儿窒息和早产。45例感染组患儿病原体检查中,共计查出64株,革兰阴性菌、解脲脲支原体、革兰阳性菌分别为46株(71.87%)、11株(17.19%)、7株(10.94%)。59例患儿的总体治疗结果为6例患儿治疗无效死亡,病死率10.17%;9例患儿放弃治疗,其余44例患儿病情得到控制,治愈出院。结论导致新生儿肺出血的重要因素为宫内感染,防止出现新生儿缺氧和感染,加强对孕妇孕产期检查、保健工作,控制孕妇孕产期情绪,避免对胎儿造成不利影响,同时对于重症感染患儿必须提高监护频率,及时发现问题,降低肺出血情况发生概率。

Objective To study and analyze the clinical treatment of neonatal pulmonary hemorrhage with intrauterine infection and discuss the main clinical features of neonatal pulmonary hemorrhage with intrauterine infection.To determine the high risk factors affecting the occurrence of neonatal pulmonary hemorrhage.Methods59cases of neonatal pulmonary hemorrhage from April2014to August2016in our hospital were compared.The clinical data were obtained as the research materials.Among them,45cases of infective children were complicated with intrauterine infection.There were14cases without intrauterine infection in uninfected group.By comparing the basic information of the two groups,the causes of pulmonary hemorrhage and intrauterine infection were summed up,and the location of intrauterine infection was counted.Pathogenic bacteria and the effectiveness of treatment methods.SPSS17.0statistical software was used to analyze the data.Results There were45cases of intrauterine infection in59cases of neonatal pulmonary hemorrhage.The information of hyaline membrane disease,asphyxia neonatorum,premature delivery and birth weight<1500g were statistically analyzed between the two groups(P<0.05).By multivariate regression analysis,the high risk factors of intrauterine infection were pulmonary hyaline membrane disease,neonatal asphyxia and premature birth.64strains of Gram-negative bacteria were found in the pathogen examination of neonatal asphyxia and premature delivery.There were46strains of Ureaplasma Urealyticum and11strains of Gram-positive bacteria,11strains of Ureaplasma Urealyticum and11strains of Gram-positive bacteria.The total treatment results of7strains10.94%and59children were as follows:6cases died without effective treatment,and the mortality rate was10.17%;9cases gave up treatment,the other44cases were cured and discharged.Conclusion Intrauterine infection is the important factor leading to neonatal pulmonary hemorrhage,so as to prevent neonatal hypoxia and infection.To strengthen the pregnant women during pregnancy and childbirth inspection,health care,control of maternal mood during pregnancy,to avoid adverse effects on the fetus,at the same time for children with severe infection must improve the frequency of monitoring,timely detection of problems.Reduce the probability of pulmonary hemorrhage.