483例早产儿并发症及院内感染病原菌分析  

Analysis of complications and nosocomial infection pathogens in 483 cases of premature infants

作　　者：张晓慧[1] 丁艳洁[1] 刘运祥[1] 初清[1] 张会芹 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院儿科,烟台264000 [2]滕州市南沙河卫生院,277500

出　　处：《中国小儿急救医学》2015年第2期119-122,共4页Chinese Pediatric Emergency Medicine

基　　金：烟台市科学技术发展计划项目（2009155-17）

摘　　要：目的分析不同胎龄及出生体重早产儿并发症情况以及感染病原菌种类。方法将2008年1月至2010年12月在我院住院的483例早产儿根据出生体重分为〈1500g、1500—2500g、≥2500g组，根据胎龄分为〈32周、32～34周、34～37周组，比较各组并发症发生率及感染病原菌种类的差异。结果（1）各系统并发症：呼吸系统并发症最为常见，除神经系统外，胎龄越小，出生体重越低，各系统并发症的发生率越高，差异均有统计学意义（P〈0．05），而神经系统并发症在不同出生体重的患儿中差异无统计学意义（P〉0．05），在32～34周胎龄组及≥2500g组发生率较其他组为高（P〈0．05）；（2）疾病种类：呼吸系统疾病、喂养不耐受、贫血、动脉导管未闭、低血糖、电解质紊乱、代谢性酸中毒在不同胎龄及出生体重组之间差异有统计学意义（P〈0．05），胎龄及出生体重越小，发生率越高；新生儿缺氧缺血性脑病、高胆红素血症在不同胎龄及出生体重组之间差异无统计学意义（P〉0．05）。（3）痰培养阳性率为14．7％（71／483），以革兰阴性杆菌为主，肺炎克雷白杆菌、假单胞菌属及鲍曼不动杆菌最为常见。不同胎龄及不同出生体重组痰培养阳性率差异有统计学意义（P〈0．05），胎龄及出生体重越小，阳性率越高。结论早产儿并发症的发生率与胎龄及出生体重有关，胎龄及出生体重越小，发生率越高。病原菌种类以革兰阴性杆菌为主，且胎龄及出生体重越小，阳性率越高。Objective To analyze the complications and infection pathogens of premature infants with different gestational age and birth body mass. Methods The 483 premature infants hospitalized in our hospital from Jan 2008 to Dec 2010 were divided into 〈 1 500 g, 1 500 - 2 500 g,≥ 2 500 g groups, respectively, according to birth weight; or were divided into 〈 32 weeks ,32-34 weeks,34 - 37 weeks groups, respectively, according to gestational age. The incidence of complications and infection pathogens among the groups were analyzed. Results （ 1 ） System complications ：respiratory complications were the most common. Except nervous system, the incidence of other system complications was higher with the smaller gestational age or birth body mass, and the differences were significant（ P 〈0. 05 ）. The incidence of nervous system complications was higher in 32-34 weeks and ≥2 500 g group than other groups （P 〈 0. 05）, while showed no significant difference among different birth body mass groups（P 〉 0. 05 ）. （2）Type of diseases：respiratory system disease, feeding intolerance, anemia, patent ductus arteriosus,hypoglycemia, electrolyte disorder, metabolic acidosis showed statistically significant differences among different gestational age or birth weight groups （ P 〈 0. 05 ）. The incidence was higher with the smaller gestational age or birth body mass. The differences of neonatal hypoxic-ischemic encephalopathy and hyperbilimbinemia among different gestational age or birth weight were not statistically significant （ P 〉 0. 05 ）. （ 3 ） A total of 14. 7% （ 71/483 ） sputum cultures were positive, and mainly showed gramnegative bacilli. Among them, Klebsiella Pneumonlae, Pseudomonas and Acinetobacter baumannii were most common. The differences of sputum bacterial culture positive rates were statistically significant in different gestational age or birth weight groups （P 〈 0. 05 ）, the smaller the gestational age or birth weight, the higher the positive rates. Conclusion A v

关 键 词：早产儿 并发症 病原菌 

分 类 号：R722.6[医药卫生—儿科]