晚期早产儿早发型败血症与早产儿脑损伤的相关性研究

Correlation between early-onset sepsis and brain injury in late preterm infants

目的观察晚期早产儿(LPI)早发型败血症合并脑损伤的临床表现。方法选取新生儿科住院LPI患儿423例,发生败血症患儿为观察组(n=104),未发生患儿为对照组(n=319)。比较2组患儿一般情况、临床表现、磁共振成像(MRI)变化、治疗及转归、28 d新生儿神经行为测定(NBNA)评分。结果观察组呼吸暂停及低血压、脑白质损伤发生率均高于对照组,差异有统计学意义(P<0.05);观察组发生脑损伤患儿有创机械通气时间、住院时长均长于对照组,新生儿坏死性小肠结肠炎(NEC)发生率、NBNA异常率均高于对照组,差异有统计学意义(P<0.05)。结论早发型败血症LPI更易发生脑损伤,院内并发症发生率和NBNA评分异常率均较高。

Objective To observe the clinical manifestations of early-onset sepsis complicated with brain injury in late preterm infants(LPI).Methods Totally 423 hospitalized infants with LPI in Department of Neonatology were selected,among which the infants with sepsis were designed as observation group(n=104),and the infants without sepsis were designed as control group(n=319).The general situation,clinical manifestations,change of magnetic resonance imaging(MRI),treatment and outcome as well as score of 28-day Neonatal Behavioral Neurological Assessment(NBNA)were compared between the two groups.Results The incidence rates of apnea,hypotension and brain white matter injury in the observation group were significantly higher than those in the control group(P<0.05).The time of invasive mechanical ventilation and hospital stay were significantly longer of the infants with brain injury in the observation group,incidence of neonatal necrotizing enterocolitis(NEC)and abnormal rate of NBNA were significantly higher than those in the control group(P<0.05).Conclusion LPI with early-onset sepsis is more prone to brain injury,and the incidence of complications in hospital and abnormal rate of NBNA score are higher.