新生儿百日咳预防及控制

Prevention and control of neonatal pertussis

目的探讨新生儿百日咳预防和控制的方法。方法回顾性收集某院8例确诊百日咳新生儿的临床资料,对一般情况、临床表现、辅助检查、治疗进行分析整理。结果 8例百日咳新生儿中仅有4例有明确的接触呼吸道感染患者病史,咳嗽从轻咳进展为痉挛性咳嗽的平均时间为(6.25±1.91)d,痉挛性咳嗽期3例(37.50%)出现呼吸困难,4例(50.00%)二氧化碳潴留,2例(25.00%)出现呼吸暂停,6例(75.00%)经皮血氧下降;7例初次感染百日咳的新生儿表现为白细胞>20×10^9/L,淋巴细胞大于60%,降钙素原小于0.5 ng/mL,百日咳杆菌聚合酶链反应均阳性,百日咳IgM抗体均阴性。8例新生儿分离的百日咳杆菌对阿奇霉素均敏感,7例治疗好转或治愈,1例放弃治疗。结论在百日咳流行季节,杜绝探视新生儿。新生儿百日咳应结合临床表现及辅助检查,尽早诊断,积极治疗,并控制百日咳疫情。

Objective To explore the methods of prevention and control of pertussis in neonates.Methods Clinical data of 8 neonates with pertussis in a hospital were collected, general condition, clinical manifestations, auxiliary examination and treatment were analyzed.Results Only 4 of 8 neonates with pertussis had a definite history of contact with patients with respiratory tract infection, the average time from mild cough to spasmodic cough was(6.25±1.91) days, 3 cases(37.50%) had dyspnea during spasmodic cough period, 4(50.00%) had carbon dioxide retention, 2(25.00%) had apnea, 6(75.00%) were with decrease transcutaneous oxygen;7 neonates with pertussis for the first times showed leukocytes>20×10^9/L, lymphocytes>60%, procalcitonin<0.5 ng/mL, polymerase chain reaction of Bordetella pertussis were all positive, and pertussis IgM antibody were all negative. Bordetella pertussis isolated from 8 neonates with pertussis were sensitive to azithromycin, 7 neonates was improved and cured, 1 neonate gave up treatment.Conclusion In the epidemic season of pertussis, it is forbidden to visit the neonate. Neonatal pertussis should be diagnosed as early as possible, treated actively and controlled epidemic according to the clinical manifestations and auxiliary examination.