极低出生体重儿晚发型败血症的危险因素分析

Risk factors analysis of late-onset septicemia in very low birth weight infants

目的 分析极低出生体重儿并发晚发型败血症(late-onset septicemia,LOS)的危险因素。方法 选取2014年1月至2021年12月余姚市人民医院收治的极低出生体重儿110例,根据住院期间是否发生LOS将其分为病例组(n=54)和对照组(n=56)。收集两组患儿的相关临床资料,采用多因素Logistic回归分析探讨极低出生体重儿并发LOS的影响因素。结果 病例组患儿的Apgar评分、抗生素治疗率显著低于对照组,气管插管率显著高于对照组,全静脉营养时间、住院时间显著长于对照组(P<0.05)。多因素Logistic回归分析显示,气管插管、无抗生素治疗、全静脉营养时间长和住院时间长均是极低出生体重儿并发LOS的独立危险因素(P<0.05)。病例组患儿的早期临床表现以呼吸暂停为主(38.89%),其次为腹胀(37.04%)。46.30%的病例组患儿血培养阳性,主要感染病原菌为肺炎克雷伯杆菌(12.96%)。结论 气管插管、无抗生素治疗、全静脉营养时间长、住院时间长是极低出生体重儿并发LOS的独立危险因素;LOS患儿早期临床表现以呼吸暂停为主,病原体以肺炎克雷伯杆菌为主,早期识别LOS高危患儿并给予医学干预可有效防治极低出生体重儿并发LOS。

Objective To analyze the risk factors of very low birth weight infants with late-onset septicemia(LOS).Methods A total of 110 very low birth weight infants admitted to Yuyao People's Hospital from January 2014 to December 2021 were selected and divided into case group(n=54) and control group(n=56) according to whether LOS occurred during hospitalization.The related clinical data of the two groups were collected,and the influencing factors of LOS in very low birth weight infants were analyzed by multivariate Logistic regression.Results The Apgar score and antibiotic treatment rate of the patients in case group were significantly lower than those in control group,the tracheal intubation rate was significantly higher than that in control group,and the total venous nutrition time and hospital stay were significantly longer than those in control group(P<0.05).Multivariate Logistic regression analysis showed that tracheal intubation,no antibiotic therapy,long duration of total intravenous nutrition and hospital stay were independent risk factors for LOS in very low birth weight infants(P<0.05).The early clinical manifestations of the patients in case group were mainly apnea(38.89%),followed by abdominal distension(37.04%).46.30% of patients in case group showed positive blood culture,and the main pathogen was Klebsiella pneumoniae(12.96%).Conclusion Tracheal intubation,no antibiotic treatment,long duration of total intravenous nutrition and hospital stay are independent risk factors for very low birth weight infants complicated with LOS.The early clinical manifestations of LOS children are mainly apnea,and Klebsiella pneumoniae is mainly pathogen.Early identification of high-risk LOS children and medical intervention can effectively prevent and treat very low birth weight infants complicated with LOS.