新生儿败血症预后不良的危险因素分析

Risk Factors for Poor Prognosis of Neonatal Septicemia

目的研究新生儿败血症预后不良的相关危险因素。方法回顾性分析2020年2月至2021年8月信阳市中心医院儿科收治的249例败血症新生儿临床一般资料,以患儿预后情况分为预后不良组(n=40)、预后良好组(n=209),观察新生儿败血症临床表现,分析新生儿败血症预后不良的相关危险因素。结果败血症新生儿中出现反应低下50例(20.08%)、黄疸25例(10.04%)、发热27例(10.84%)、吐奶15例(6.02%)、喂养困难32例(12.85%)、面色青灰49例(19.68%)、呼吸窘迫51例(20.48%);预后不良组性别、疾病类型、血压、尿量、血小板及白细胞计数与预后良好组比较,差异无统计学意义(P>0.05);两组早产儿、机械通气、坏死性小肠结肠炎和感染性休克比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,早产儿、机械通气、坏死性小肠结肠炎和感染性休克是新生儿败血症预后不良的危险因素(OR>1,P<0.05)。结论败血症新生儿常出现反应低下、面色青灰、呼吸窘迫情况,且早产儿、机械通气、坏死性小肠结肠炎和感染性休克是新生儿败血症预后不良的危险因素,临床应做好早期危险因素识别工作,同时积极采取针对性预防措施,以降低新生儿败血症预后不良发生风险。

Objective To study the related risk factors of poor prognosis in neonatal septicemia.Methods The clinical data of 249 neonates with septicemia admitted to the Department of Pediatrics of Xinyang Central Hospital from February 2020 to August 2021 were retrospectively analyzed.They were divided into poor prognosis group(n=40)and good prognosis group(n=209)according to the prognosis of the patients.To observe the clinical manifestations of neonatal septicemia and analyze the related risk factors of poor prognosis of neonates with septicemia.Results There were 50 cases of hyporesponsiveness(20.08%),25 cases of jaundice(10.04%),27 cases of fever(10.84%),15 cases of vomiting(6.02%),32 cases of feeding difficulties(12.85%),49 cases of pale complexion(19.68%),51 cases of respiratory distress(20.48%)among neonatal septicemia.Compared between the poor prognosis group and the good prognosis group in sex,disease type,blood pressure,urine volume,platelet and leukocyte count,there was no significant difference(P>0.05).There were statistical differences between the two groups in preterm infants,mechanical ventilation,necrotizing enterocolitis and septic shock(P<0.05).Multivariate logistic regression showed that premature infants,mechanical ventilation,necrotizing enterocolitis and septic shock were risk factors for poor prognosis of neonatal septicemia(OR>1,P<0.05).Conclusion The main clinical manifestations of neonatal septicemia are hyporesponsiveness,pale complexion and respiratory distress,and premature infants,mechanical ventilation,necrotizing enterocolitis and septic shock are the risk factors for poor prognosis of neonatal septicemia.It is necessary to identify the risk factors as early as possible and take targeted preventive measures to reduce the risk of poor prognosis of neonatal septicemia.