早产儿与足月儿败血症临床特征对比研究  

A comparative analysis of clinical characteristics in preterm and full-term infants with sepsis

作　　者：成大欣[1,2] 王小娟[1] 芦红茹[1] 张勤[1] 程凤娜[1] 

机构地区：[1]陕西省人民医院新生儿科,西安710068 [2]西安交通大学心血管研究中心动脉硬化与脂代谢实验室

出　　处：《山西医科大学学报》2017年第12期1291-1294,共4页Journal of Shanxi Medical University

基　　金：陕西省自然科学基金资助项目(2016JM8061);陕西省卫生厅科研基金扶植项目(2014D38)

摘　　要：目的分析早产儿和足月儿败血症的高危因素及临床特征,为降低败血症发病率、死亡率及早期诊断提供科学理论依据。方法收集2014-01~2016-12确定诊断早产儿败血症127例与足月儿败血症41例,比较两组围产期高危因素、感染途径、临床表现、实验室指标、并发症差异。结果早产儿败血症组剖宫产、妊娠期高血压、呼吸窘迫综合征、深静脉置管、机械通气、抗生素应用等比例均显著高于足月儿组(P<0.05)。早产儿败血症多经呼吸道感染(44.1%),足月儿组多经血流感染(65.9%)。两组比较,早产儿组易出现氧饱和度下降(65.4%vs 14.6%)、呼吸困难(40.2%vs 12.2%)、呼吸暂停(28.3%vs 9.8%)和应激性高血糖(38.6%vs 14.6%);足月儿组易出现黄疸(61%vs 32.3%)和体温异常(53.7%vs17.3%)。足月儿组白细胞计数、PCT值增高比例显著多于早产儿组(P<0.05);早产儿组白细胞计数减低,血小板减低比例显著多于足月儿组(P<0.05)。两组并发症及病死率差异无统计学意义。结论早产儿败血症高危因素多,临床表现、实验室指标与足月儿败血症存在一定差异,在制定治疗方案时应予关注。Objective To analyze the risk factors and clinical characteristics of preterm infants and full-term infants for providing a scientific basis for early diagnosis and reducing the morbidity. Methods Totally 127 preterm infants and 41 full-term infants with septicemia were collected from January 2014 to December 2016,and the high-risk factors,infection pathways,clinical manifestations,laboratory indicators and complications differences were analyzed in two groups. Results The proportion of cesarean section,pregnancy hypertension,respiratory distress syndrome,deep venous catheter,mechanical ventilation and antibiotic application were significantly higher in preterm patients than those in full-term patients（ P〈0. 05）. The main infection pathway was multiple respiratory infection in preterm infants with sepsis（ 44. 1%） and blood flow in full-term infants（ 65. 9%）. The preterm infants were prone to manifesting the decrease of oxygen saturation（ 65. 4% vs 14. 6%）,dyspnea（ 40. 2% vs 12. 2%）,apnea（ 28. 3% vs 9. 8%） and stress hyperglycemia（ 38. 6% vs 14. 6%）,while the full-term infants were prone to having jaundice（ 61. 0% vs 32. 3%） and abnormal body temperature（ 53. 7% vs 17. 3%）. The white cell count and PCT value in full-term infants was significantly higher than that of preterm infants（ P〈0. 05）. In preterm infants,the proportions of decreased white cell count and thrombocytopenia were significantly higher than those of full-term infants group（ P〈0. 05）. There was no statistically significant difference in complication and fatality rate between the two groups. Conclusion There are more risk factors of sepsis in preterm infants than that of full-term infants. Clinical characteristics and laboratory data are also different between preterm and full-term infants. These should be paid attention in making the treatment procedure.

关 键 词：败血症 早产儿 足月儿 

分 类 号：R722.131[医药卫生—儿科]