早产儿晚发型败血症发病的相关因素研究

Study on related factors of late-onset sepsis in premature infants

目的探讨早产儿晚发型败血症发病的相关危险因素,为降低其发病率提供临床依据。方法选取2019年1月至2020年12月台州市妇女儿童医院新生儿科收治的94例晚发型败血症早产儿为观察组,选取同期102例未并发晚发型败血症的早产儿为对照组,比较两组患儿的临床资料,分析早产儿晚发型败血症发病的危险因素。结果两组患儿的日龄、性别、分娩方式、抗菌药物使用时间差异均无统计学意义(P>0.05)。观察组的体重、胎龄均显著低于对照组(t值分别为2.081、2.023,P<0.05);两组的留置胃管时间、机械通气时间、胎膜早破时间、动脉血乳酸水平、C反应蛋白水平、降钙素原水平、血小板体积、中性粒细胞百分比差异均有统计学意义(t值分别为2.134、2.315、2.176、2.502、2.417、5.559、2.469、2.368,P<0.05)。Logistic回归分析显示,低体重、低胎龄、机械通气时间长、胎膜早破时间长、高动脉血乳酸水平、高C反应蛋白水平、高降钙素原水平、高血小板体积、高中性粒细胞百分比均是早产儿晚发型败血症发病的危险因素(Waldχ^(2)值分别为5.545、5.166、8.233、4.951、6.062、5.083、6.731、4.788、5.166,P<0.05)。结论早产儿晚发型败血症发病与低体重、低胎龄、机械通气时间长、胎膜早破时间长、高动脉血乳酸水平、高C反应蛋白水平、高降钙素原水平、高血小板体积、高中性粒细胞密切相关,临床上应加以重视。

Objective To explore the related risk factors of late-onset sepsis in premature infants and provide clinical evidence for reducing the incidence of late-onset sepsis in premature infants.Methods 94 premature infants with late-onset sepsis admitted to Women′s and Children′s Hospital of Taizhou City from January 2019 to December 2020 were selected as the observation group,and 102 premature infants without late-onset sepsis during the same period were selected as the control group.The clinical data of the two groups were compared.The risk factors of late-onset sepsis in preterm infants were analyzed.Results There were no significant differences between the two groups of children in age,gender,mode of delivery,and time of use of antibacterial drugs(P>0.05).The weight and gestational age of the observation group were significantly lower than those of the control group(t=2.081 and 2.023,respectively,both P<0.05).There were statistically significant differences in the time of indwelling gastric tube,mechanical ventilation time,premature rupture of membranes,arterial blood lactic acid,C-reactive protein,procalcitonin,average platelet volume,and neutrophil percentage between the two groups(t=2.134,2.315,2.176,2.502,2.417,5.559,2.469 and 2.368,respectively,all P<0.05).Logistic regression revealed that low body weight,low gestational age,long invasive treatment time,long premature rupture of membranes,high arterial blood lactate,high C-reactive protein,high procalcitonin,high average platelet volume,and a high percentage of neutrophils were all risk factors for late-onset sepsis in premature infants(Waldχ^(2)=5.545,5.166,8.233,4.951,6.062,5.083,6.731,4.788 and 5.166,respectively,all P<0.05).Conclusion The onset of late-onset sepsis in premature infants is closely related to low body weight,low gestational age,long mechanical ventilation time,long premature rupture of membranes,high arterial blood lactate,C-reactive protein,procalcitonin,platelet volume,and neutrophils.They should be valued clinically.